IB 
Union Calendar No. 424 
116TH CONGRESS 
2D SESSION 
H. R. 2271 
[Report No. 116–524] 
To amend the Public Health Service Act to improve the health of children 
and help better understand and enhance awareness about unexpected 
sudden death in early life. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 10, 2019 
Ms. MOORE
(for herself, Mr. COLE, Ms. HERRERA
BEUTLER, Mr. 
GOTTHEIMER, Ms. CLARKE of New York, Mrs. RODGERS of Washington, 
Ms. WASSERMAN SCHULTZ, Mr. GRIJALVA, Mr. KHANNA, Ms. NORTON, 
Mr. KING of New York, Ms. MCCOLLUM, Mr. CARTWRIGHT, and Ms. 
DELBENE) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
SEPTEMBER 21, 2020 
Additional sponsors: Mr. RYAN, Ms. SEWELL of Alabama, Mr. FITZPATRICK, 
Ms. DELAURO, Mr. HECK, Mr. WITTMAN, Mrs. WATSON COLEMAN, Ms. 
FUDGE, Mr. NEGUSE, Mr. LAWSON of Florida, Mr. PAYNE, Mr. THOMP-
SON of Mississippi, Mr. RICHMOND, Mr. CLEAVER, Mr. CLYBURN, Mr. 
GREEN of Texas, Mrs. DEMINGS, Ms. PRESSLEY, Ms. KELLY of Illinois, 
Ms. JOHNSON of Texas, Ms. BASS, Ms. WILSON of Florida, Mr. EVANS, 
Mr. JOHNSON of Georgia, Mrs. LAWRENCE, Ms. JACKSON LEE, Mr. 
MEEKS, Mr. KIND, Mr. HASTINGS, Ms. ROYBAL-ALLARD, Mr. DANNY K. 
DAVIS of Illinois, Mr. RASKIN, Ms. BLUNT ROCHESTER, Mr. KENNEDY, 
Mr. CASE, Mr. COHEN, Mr. HARDER of California, Mr. LIPINSKI, Mr. 
GARCI´A of Illinois, Mr. MCGOVERN, Mr. LYNCH, Mr. PETERSON, Ms. 
PINGREE, Mr. MICHAEL F. DOYLE of Pennsylvania, Ms. SCHRIER, Ms. 
SHERRILL, Ms. SPANBERGER, Mr. COOPER, Mr. RUSH, Ms. CRAIG, Mr. 
UPTON, Mr. GUTHRIE, Ms. KUSTER of New Hampshire, Mrs. AXNE, Mr. 
SWALWELL of California, Mr. YOUNG, Mr. COX of California, Mr. SOTO, 
Mr. CONNOLLY, and Mr. BURGESS 
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SEPTEMBER 21, 2020 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on April 10, 2019] 
A BILL 
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. 
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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 ‘‘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 ‘‘SUDDEN 
UNEXPECTED
INFANT
DEATH, SUDDEN
INFANT 
DEATH
SYNDROME, 
AND
SUDDEN
UNEXPECTED 
DEATH IN CHILDHOOD’’; and 
(2) by inserting before section 1122 the following: 
‘‘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 
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Case Registry of the Centers for Disease Control and 
Prevention and other fatality case reporting systems 
that include data pertaining to sudden unexpected in-
fant 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 
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‘‘(2) awarding grants or cooperative agreements 
to States, Indian Tribes, and Tribal organizations for 
purposes of— 
‘‘(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 enforce-
ment personnel, emergency medical techni-
cians, paramedics, emergency department 
personnel, and others who perform death 
scene investigations with respect to the 
deaths of infants and children, as appro-
priate; 
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‘‘(C) identifying, developing, and imple-
menting best practices to reduce or prevent sud-
den unexpected infant death and sudden unex-
pected 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 unex-
pected infant death and sudden unexpected death 
in childhood, of samples of tissues or genetic ma-
terials 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 information on 
risk factors that contribute to sleep-related sud-
den unexpected infant death or sudden unex-
pected 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 require, 
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including information on how such State will ensure activi-
ties conducted under this section are coordinated 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 activi-
ties funded through the grant or cooperative agreement. 
‘‘(d) REPORTING FORMS.— 
‘‘(1) IN GENERAL.—The Secretary shall, as ap-
propriate, encourage the use of sudden unexpected in-
fant death and sudden unexpected death in childhood 
reporting forms developed in collaboration with the 
Centers for Disease Control and Prevention to im-
prove 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 unex-
pected infant death investigation reporting form used 
by the Centers for Disease Control and Prevention in 
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order to improve the use of such form with other fa-
tality case reporting systems supported by the De-
partment 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 na-
tional organizations, State and local health depart-
ments, community-based organizations, and nonprofit 
organizations for the provision of support services to 
families who have had a child die of sudden unex-
pected 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, re-
sources, 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 fam-
ilies who have lost a child to sudden unexpected 
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 direct 
support services and interventions for sudden 
unexpected infant death and sudden unexplained 
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 child-
hood’— 
‘‘(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 child-
hood that remains unexplained after a thorough case 
investigation. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized to 
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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, Education, 
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 sud-
den unexpected deaths in childhood (including the 
number of such infant and child deaths that remain 
unexplained after investigation), including, to the ex-
tent 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 various 
approaches of reducing and preventing sudden unex-
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pected 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 ‘‘sudden 
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). 
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Union Calendar No. 424 
116TH CONGRESS 
2D SESSION 
H. R. 2271 
[Report No. 116–524] 
A BILL 
To amend the Public Health Service Act to improve 
the health of children and help better understand 
and enhance awareness about unexpected sudden 
death in early life. 
SEPTEMBER 21, 2020 
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union, 
and ordered to be printed 
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