I
104TH CONGRESS
1ST SESSION
H. R. 1263
To establish a program that would assist abandoned and medically fragile
infants.
IN THE HOUSE OF REPRESENTATIVES
MARCH 16, 1995
Mr. PAYNE of New Jersey introduced the following bill; which was referred
to the Committee on Economic and Educational Opportunities
A BILL
To establish a program that would assist abandoned and
medically fragile infants.
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 ‘‘Abandoned and Medi-
cally Fragile Infants Assistance Act of 1995’’.
SEC. 2. FINDINGS.
The Congress finds that—
(1) throughout the Nation, the number of in-
fants and young children who have been exposed to
drugs taken by their mothers during pregnancy has
increased dramatically;
(2) the inability of parents who abuse drugs to
provide adequate care for such infants and young
children and a lack of suitable shelter homes for
such infants and young children have led to the
abandonment of such infants and young children in
hospitals for extended periods;
(3) an unacceptable number of these infants
and young children will be medically cleared for dis-
charge, yet remain in hospitals as boarder babies;
(4) hospital-based child care for these infants
and young children is extremely costly and deprives
them of an adequate nurturing environment;
(5) training is inadequate for foster care per-
sonnel working with medically fragile infants and
young children and infants and young children ex-
posed to drugs;
(6) a particularly devastating development is
the increase in the number of infants and young
children 
who 
are 
infected 
with 
the 
human
immunodeficiency virus (which is believed to cause
acquired immune deficiency syndrome and which is
commonly known as HIV) or who have been
perinatally exposed to the virus or to a dangerous
drug;
(7) many such infants and young children have
at least one parent who is an intravenous drug
abuser;
(8) such infants and young children are par-
ticularly difficult to place in foster homes, and are
being abandoned in hospitals in increasing numbers
by mothers dying of acquired immune deficiency
syndrome, or by parents incapable of providing ade-
quate care;
(9) there is a need for comprehensive services
for such infants and young children, including foster
family care services, case management services, fam-
ily support services, respite and crisis intervention
services, counseling services, and group residential
home services;
(10) there is a need to support the families of
such infants and young children through the provi-
sion of services that will prevent the abandonment of
the infants and children; and
(11) there is a need for the development of
funding strategies that coordinate and make the op-
timal use of all private resources, and Federal,
State, and local resources, to establish and maintain
such services.
SEC. 3. GRANTS FOR PROJECTS REGARDING ABANDON-
MENT OF INFANTS AND YOUNG CHILDREN IN
HOSPITALS.
(a) IN GENERAL.—The Secretary of Health and
Human Services may make grants to public and nonprofit
private entities for the purpose of developing, implement-
ing, and operating projects—
(1) to prevent the abandonment of infants and
young children, including the provision of services to
members of the natural family for any condition that
increases the probability of abandonment of an in-
fant or young child;
(2) to identify and address the needs of aban-
doned infants and young children;
(3) to assist abandoned infants and young chil-
dren to reside with their natural families or in foster
care, as appropriate;
(4) to recruit, train, and retain foster families
for abandoned infants and young children;
(5) to carry out residential care programs for
abandoned infants and young children who are un-
able to reside with their families or to be placed in
foster care;
(6) to carry out programs of respite care for
families and foster families of infants and young
children described in subsection (b);
(7) to recruit and train health and social serv-
ices personnel to work with families, foster care fam-
ilies, and residential care programs for abandoned
infants and young children; and
(8) to prevent the abandonment of infants and
young children, and to care for the infants and
young children who have been abandoned, through
model programs providing health, educational, and
social services at a single site in a geographic area
in which a significant number of infants and young
children described in subsection (b) reside (with spe-
cial consideration given to applications from entities
that will provide the services of the project through
community-based organizations).
(b) PRIORITY IN PROVISION OF SERVICES.—The Sec-
retary may not make a grant under subsection (a) unless
the applicant for the grant agrees that, in carrying out
the purpose described in subsection (a) (other than with
respect to paragraph (6) of such subsection), the applicant
will give priority to abandoned infants and young chil-
dren—
(1) 
who 
are 
infected 
with 
the 
human
immunodeficiency virus or who have been perinatally
exposed to the virus; or
(2) who have been perinatally exposed to a dan-
gerous drug.
(c) CASE PLAN WITH RESPECT TO FOSTER CARE.—
The Secretary may not make a grant under subsection (a)
unless the applicant for the grant agrees that, if the appli-
cant expends the grant to carry out any program of pro-
viding care to infants and young children in foster homes
or in other nonmedical residential settings away from their
parents, the applicant will ensure that—
(1) a case plan of the type described in para-
graph (1) of section 475 of the Social Security Act
is developed for each such infant and young child (to
the extent that such infant and young child is not
otherwise covered by such a plan); and
(2) the program includes a case review system
of the type described in paragraph (5) of such sec-
tion (covering each such infant and young child who
is not otherwise subject to such a system).
(d) ADMINISTRATION OF GRANT.—
(1) The Secretary may not make a grant under
subsection (a) unless the applicant for the grant
agrees—
(A) to use the funds provided under this
section only for the purposes specified in the
application submitted to, and approved by, the
Secretary pursuant to subsection (e);
(B) to establish such fiscal control and
fund accounting procedures as may be nec-
essary to ensure proper disbursement and ac-
counting of Federal funds paid to the applicant
under this section; and
(C) to report to the Secretary annually on
the utilization, cost, and outcome of activities
conducted, and services furnished, under this
section.
(e) REQUIREMENT OF APPLICATION.—The Secretary
may not make a grant under subsection (a) unless—
(1) an application for the grant is submitted to
the Secretary;
(2) with respect to carrying out the purpose for
which the grant is to be made, the application pro-
vides assurances of compliance satisfactory to the
Secretary; and
(3) the application otherwise is in such form, is
made in such manner, and contains such agree-
ments, assurances, and information as the Secretary
determines to be necessary to carry out this section.
SEC. 4. GRANTS TO PROVIDE NURTURING HOME ENVIRON-
MENTS AND FAMILY-CENTERED SERVICES
FOR MEDICALLY FRAGILE INFANTS.
The Secretary may make grants to public and non-
profit entities for the purposes of developing, implement-
ing, or operating—
(1) programs and activities to prevent the medi-
cal neglect of disabled infants with life-threatening
conditions;
(2) information, education, and training pro-
grams designed to improve the provision of services
to disabled infants with life-threatening conditions
for—
(A) professional and paraprofessional per-
sonnel concerned with the welfare of disabled
infants with life-threatening conditions, includ-
ing personnel employed in child protective serv-
ices programs and health care facilities; and
(B) the parents of such infants; and
(3) programs to assist in obtaining or coordi-
nating necessary services for families of disabled in-
fants with life-threatening conditions, including—
(A) existing social and health services;
(B) financial assistance; and
(C) services necessary to facilitate adoptive
placement of any such infant who is legally free
for adoption.
SEC. 5. EVALUATIONS, STUDIES, AND REPORTS BY SEC-
RETARY.
The Secretary shall, directly or through contracts
with public and nonprofit private entities, provide for eval-
uations of projects carried out under this Act and for the
dissemination of information developed as result of such
projects.
SEC. 6. DEFINITIONS.
For purposes of this Act:
(1) The terms ‘‘abandoned’’ and ‘‘abandon-
ment’’, with respect to infants and young children,
mean that the infants and young children are medi-
cally cleared for discharge from acute-care hospital
settings, but remain hospitalized because of a lack of
appropriate out-of-hospital placement alternatives.
(2) The term ‘‘dangerous drug’’ means a con-
trolled substance, as defined in section 102 of the
Controlled Substances Act (21 U.S.C. 802).
(3) The term ‘‘natural family’’ shall be broadly
interpreted to include natural parents, grandparents,
family members, guardians, children residing in the
Household, and individuals residing in the household
on a continuing basis who are in a care-giving situa-
tion with respect to infants and young children cov-
ered under this Act.
(4) The term ‘‘acquired immune deficiency syn-
drome’’ includes infection with the etiologic agent
for such syndrome, any condition indicating that an
individual is infected with such etiologic agent, and
any condition arising from such etiologic agent.
(5) The term ‘‘Secretary’’ means the Secretary
of Health and Human Services.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS.
(a) IN GENERAL.—For the purpose of carrying out
this Act, there are authorized to be appropriated
$15,000,000 for fiscal year 1996 and such sums as may
be necessary for each of the fiscal years 1997, 1998, 1999,
and 2000.
(b) AVAILABILITY
OF
FUNDS.—Amounts appro-
priated under this section shall remain available until ex-
pended.
(1) 
CONFORMING
AMENDMENT.—Section
421(7) of the Domestic Volunteer Service Act of
1973 (42 U.S.C. 5061(7)) is amended to read as fol-
lows:
‘‘(7) the term ‘border baby’ means an infant de-
scribed in section 6(1) of the Abandoned and Medi-
cally Fragile Infants Assistance Act of 1995.’’.
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