IIB 
111TH CONGRESS 
1ST SESSION 
H. R. 911 
IN THE SENATE OF THE UNITED STATES 
FEBRUARY 24, 2009 
Received; read twice and referred to the Committee on Health, Education, 
Labor, and Pensions 
AN ACT 
To require certain standards and enforcement provisions to 
prevent child abuse and neglect in residential programs, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Stop Child Abuse in 
Residential Programs for Teens Act of 2009’’. 
SEC. 2. DEFINITIONS. 
In this Act: 
(1) ASSISTANT SECRETARY.—The term ‘‘Assist-
ant Secretary’’ means the Assistant Secretary for 
Children and Families of the Department of Health 
and Human Services. 
(2) CHILD.—The term ‘‘child’’ means an indi-
vidual who has not attained the age of 18. 
(3) CHILD ABUSE AND NEGLECT.—The term 
‘‘child abuse and neglect’’ has the meaning given 
such term in section 111 of the Child Abuse Preven-
tion and Treatment Act (42 U.S.C. 5106g). 
(4) COVERED PROGRAM.— 
(A) IN GENERAL.—The term ‘‘covered pro-
gram’’ means each location of a program oper-
ated by a public or private entity that, with re-
spect to one or more children who are unrelated 
to the owner or operator of the program— 
(i) provides a residential environment, 
such as— 
(I) a program with a wilderness 
or outdoor experience, expedition, or 
intervention; 
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(II) a boot camp experience or 
other experience designed to simulate 
characteristics of basic military train-
ing or correctional regimes; 
(III) 
a 
therapeutic 
boarding 
school; or 
(IV) a behavioral modification 
program; and 
(ii) operates with a focus on serving 
children with— 
(I) emotional, behavioral, or men-
tal health problems or disorders; or 
(II) problems with alcohol or sub-
stance abuse. 
(B) EXCLUSION.—The term ‘‘covered pro-
gram’’ does not include— 
(i) a hospital licensed by the State; or 
(ii) a foster family home that provides 
24-hour substitute care for children placed 
away from their parents or guardians and 
for whom the State child welfare services 
agency has placement and care responsi-
bility and that is licensed and regulated by 
the State as a foster family home. 
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(5) PROTECTION AND ADVOCACY SYSTEM.—The 
term ‘‘protection and advocacy system’’ means a 
protection and advocacy system established under 
section 143 of the Developmental Disabilities Assist-
ance and Bill of Rights Act of 2000 (42 U.S.C. 
15043). 
(6) STATE.—The term ‘‘State’’ has the mean-
ing given such term in section 111 of the Child 
Abuse Prevention and Treatment Act. 
SEC. 3. STANDARDS AND ENFORCEMENT. 
(a) MINIMUM STANDARDS.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the As-
sistant Secretary for Children and Families of the 
Department of Health and Human Services shall re-
quire each covered program, in order to provide for 
the basic health and safety of children at such a pro-
gram, to meet the following minimum standards: 
(A) Child abuse and neglect shall be pro-
hibited. 
(B) Disciplinary techniques or other prac-
tices that involve the withholding of essential 
food, water, clothing, shelter, or medical care 
necessary to maintain physical health, mental 
health, and general safety, shall be prohibited. 
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(C) The protection and promotion of the 
right of each child at such a program to be free 
from physical and mechanical restraints and se-
clusion (as such terms are defined in section 
595 of the Public Health Service Act (42 
U.S.C. 290jj)) to the same extent and in the 
same manner as a non-medical, community- 
based facility for children and youth is required 
to protect and promote the right of its residents 
to be free from such restraints and seclusion 
under such section 595, including the prohibi-
tions and limitations described in subsection 
(b)(3) of such section. 
(D) Acts of physical or mental abuse de-
signed to humiliate, degrade, or undermine a 
child’s self-respect shall be prohibited. 
(E) Each child at such a program shall 
have reasonable access to a telephone, and be 
informed of their right to such access, for mak-
ing and receiving phone calls with as much pri-
vacy as possible, and shall have access to the 
appropriate State or local child abuse reporting 
hotline number, and the national hotline num-
ber referred to in subsection (c)(2). 
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(F) Each staff member, including volun-
teers, at such a program shall be required, as 
a condition of employment, to become familiar 
with what constitutes child abuse and neglect, 
as defined by State law. 
(G) Each staff member, including volun-
teers, at such a program shall be required, as 
a condition of employment, to become familiar 
with the requirements, including with State law 
relating to mandated reporters, and procedures 
for reporting child abuse and neglect in the 
State in which such a program is located. 
(H) Full disclosure, in writing, of staff 
qualifications and their roles and responsibil-
ities at such program, including medical, emer-
gency response, and mental health training, to 
parents or legal guardians of children at such 
a program, including providing information on 
any staff changes, including changes to any 
staff member’s qualifications, roles, or respon-
sibilities, not later than 10 days after such 
changes occur. 
(I) Each staff member at a covered pro-
gram described in subclause (I) or (II) of sec-
tion 2(4)(A)(i) shall be required, as a condition 
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of employment, to be familiar with the signs, 
symptoms, and appropriate responses associated 
with heatstroke, dehydration, and hypothermia. 
(J) Each staff member, including volun-
teers, shall be required, as a condition of em-
ployment, to submit to a criminal history check, 
including a name-based search of the National 
Sex Offender Registry established pursuant to 
the Adam Walsh Child Protection and Safety 
Act of 2006 (Public Law 109–248; 42 U.S.C. 
16901 et seq.), a search of the State criminal 
registry or repository in the State in which the 
covered program is operating, and a Federal 
Bureau of Investigation fingerprint check. An 
individual shall be ineligible to serve in a posi-
tion with any contact with children at a covered 
program if any such record check reveals a fel-
ony conviction for child abuse or neglect, spous-
al abuse, a crime against children (including 
child pornography), or a crime involving vio-
lence, including rape, sexual assault, or homi-
cide, but not including other physical assault or 
battery. 
(K) Policies and procedures for the provi-
sion of emergency medical care, including poli-
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cies for staff protocols for implementing emer-
gency responses. 
(L) All promotional and informational ma-
terials produced by such a program shall in-
clude a hyperlink to or the URL address of the 
website created by the Assistant Secretary pur-
suant to subsection (c)(1)(A). 
(M) Policies to require parents or legal 
guardians of a child attending such a pro-
gram— 
(i) to notify, in writing, such program 
of any medication the child is taking; 
(ii) to be notified within 24 hours of 
any changes to the child’s medical treat-
ment and the reason for such change; and 
(iii) to be notified within 24 hours of 
any missed dosage of prescribed medica-
tion. 
(N) Procedures for notifying immediately, 
to the maximum extent practicable, but not 
later than within 48 hours, parents or legal 
guardians with children at such a program of 
any— 
(i) on-site investigation of a report of 
child abuse and neglect; 
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(ii) violation of the health and safety 
standards described in this paragraph; and 
(iii) violation of State licensing stand-
ards 
developed 
pursuant 
to 
section 
114(b)(1) of the Child Abuse Prevention 
and Treatment Act, as added by section 7 
of this Act. 
(O) Other standards the Assistant Sec-
retary determines appropriate to provide for the 
basic health and safety of children at such a 
program. 
(2) REGULATIONS.— 
(A) INTERIM
REGULATIONS.—Not later 
than 180 days after the date of the enactment 
of this Act, the Assistant Secretary shall pro-
mulgate and enforce interim regulations to 
carry out paragraph (1). 
(B) PUBLIC
COMMENT.—The Assistant 
Secretary shall, for a 90-day period beginning 
on the date of the promulgation of interim reg-
ulations under subparagraph (A) of this para-
graph, solicit and accept public comment con-
cerning such regulations. Such public comment 
shall be submitted in written form. 
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(C) FINAL REGULATIONS.—Not later than 
90 days after the conclusion of the 90-day pe-
riod referred to in subparagraph (B) of this 
paragraph, the Assistant Secretary shall pro-
mulgate and enforce final regulations to carry 
out paragraph (1). 
(b) MONITORING AND ENFORCEMENT.— 
(1) ON-GOING
REVIEW
PROCESS.—Not later 
than 180 days after the date of the enactment of 
this Act, the Assistant Secretary shall implement an 
on-going review process for investigating and evalu-
ating reports of child abuse and neglect at covered 
programs received by the Assistant Secretary from 
the appropriate State, in accordance with section 
114(b)(3) of the Child Abuse Prevention and Treat-
ment Act, as added by section 7 of this Act. Such 
review process shall— 
(A) include an investigation to determine if 
a violation of the standards required under sub-
section (a)(1) has occurred; 
(B) include an assessment of the State’s 
performance with respect to appropriateness of 
response to and investigation of reports of child 
abuse and neglect at covered programs and ap-
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propriateness of legal action against responsible 
parties in such cases; 
(C) be completed not later than 60 days 
after receipt by the Assistant Secretary of such 
a report; 
(D) not interfere with an investigation by 
the State or a subdivision thereof; and 
(E) be implemented in each State in which 
a covered program operates until such time as 
each such State has satisfied the requirements 
under section 114(c) of the Child Abuse Pre-
vention and Treatment Act, as added by section 
7 of this Act, as determined by the Assistant 
Secretary, or two years has elapsed from the 
date that such review process is implemented, 
whichever is later. 
(2) CIVIL
PENALTIES.—Not later than 180 
days after the date of the enactment of this Act, the 
Assistant Secretary shall promulgate regulations es-
tablishing civil penalties for violations of the stand-
ards required under subsection (a)(1). The regula-
tions establishing such penalties shall incorporate 
the following: 
(A) Any owner or operator of a covered 
program at which the Assistant Secretary has 
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found a violation of the standards required 
under subsection (a)(1) may be assessed a civil 
penalty not to exceed $50,000 per violation. 
(B) All penalties collected under this sub-
section shall be deposited in the appropriate ac-
count of the Treasury of the United States. 
(c) DISSEMINATION OF INFORMATION.—The Assist-
ant Secretary shall establish, maintain, and disseminate 
information about the following: 
(1) Websites made available to the public that 
contain, at a minimum, the following: 
(A) The name and each location of each 
covered program, and the name of each owner 
and operator of each such program, operating 
in each State, and information regarding— 
(i) each such program’s history of vio-
lations of— 
(I) regulations promulgated pur-
suant to subsection (a); and 
(II) section 114(b)(1) of the 
Child Abuse Prevention and Treat-
ment Act, as added by section 7 of 
this Act; 
(ii) each such program’s current sta-
tus with the State licensing requirements 
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under section 114(b)(1) of the Child Abuse 
Prevention and Treatment Act, as added 
by section 7 of this Act; 
(iii) any deaths that occurred to a 
child while under the care of such a pro-
gram, including any such deaths that oc-
curred in the five-year period immediately 
preceding the date of the enactment of this 
Act, and including the cause of each such 
death; 
(iv) owners or operators of a covered 
program that was found to be in violation 
of the standards required under subsection 
(a)(1), or a violation of the licensing stand-
ards 
developed 
pursuant 
to 
section 
114(b)(1) of the Child Abuse Prevention 
and Treatment Act, as added by section 7 
of this Act, and who subsequently own or 
operate another covered program; and 
(v) any penalties levied under sub-
section (b)(2) and any other penalties lev-
ied by the State, against each such pro-
gram. 
(B) Information on best practices for help-
ing adolescents with mental health disorders, 
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conditions, behavioral challenges, or alcohol or 
substance abuse, including information to help 
families access effective resources in their com-
munities. 
(2) A national toll-free telephone hotline to re-
ceive complaints of child abuse and neglect at cov-
ered programs and violations of the standards re-
quired under subsection (a)(1). 
(d) ACTION.—The Assistant Secretary shall establish 
a process to— 
(1) ensure complaints of child abuse and ne-
glect received by the hotline established pursuant to 
subsection (c)(2) are promptly reviewed by persons 
with expertise in evaluating such types of com-
plaints; 
(2) immediately notify the State, appropriate 
local law enforcement, and the appropriate protec-
tion and advocacy system of any credible complaint 
of child abuse and neglect at a covered program re-
ceived by the hotline; 
(3) investigate any such credible complaint not 
later than 30 days after receiving such complaint to 
determine if a violation of the standards required 
under subsection (a)(1) has occurred; and 
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(4) ensure the collaboration and cooperation of 
the hotline established pursuant to subsection (c)(2) 
with other appropriate National, State, and regional 
hotlines, and, as appropriate and practicable, with 
other hotlines that might receive calls about child 
abuse and neglect at covered programs. 
SEC. 4. ENFORCEMENT BY THE ATTORNEY GENERAL. 
If the Assistant Secretary determines that a violation 
of subsection (a)(1) of section 3 has not been remedied 
through the enforcement process described in subsection 
(b)(2) of such section, the Assistant Secretary shall refer 
such violation to the Attorney General for appropriate ac-
tion. Regardless of whether such a referral has been made, 
the Attorney General may, sua sponte, file a complaint 
in any court of competent jurisdiction seeking equitable 
relief or any other relief authorized by this Act for such 
violation. 
SEC. 5. REPORT. 
Not later than one year after the date of the enact-
ment of this Act and annually thereafter, the Secretary 
of Health and Human Services, in coordination with the 
Attorney General shall submit to the Committee on Edu-
cation and Labor of the House of Representatives and the 
Committee on Health, Education, Labor, and Pensions of 
the Senate, a report on the activities carried out by the 
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Assistant Secretary and the Attorney General under this 
Act, including— 
(1) a summary of findings from on-going re-
views conducted by the Assistant Secretary pursuant 
to section 3(b)(1), including a description of the 
number and types of covered programs investigated 
by the Assistant Secretary pursuant to such section; 
(2) a description of types of violations of health 
and safety standards found by the Assistant Sec-
retary and any penalties assessed; 
(3) a summary of State progress in meeting the 
requirements of this Act, including the requirements 
under section 114 of the Child Abuse Prevention 
and Treatment Act, as added by section 7 of this 
Act; 
(4) a summary of the Secretary’s oversight ac-
tivities and findings conducted pursuant to sub-
section (d) of such section 114; and 
(5) a description of the activities undertaken by 
the national toll-free telephone hotline established 
pursuant to section 3(c)(2). 
SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 
There is authorized to be appropriated to the Sec-
retary of Health and Human Services $15,000,000 for 
each of fiscal years 2010 through 2014 to carry out this 
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Act (excluding the amendment made by section 7 of this 
Act and section 8 of this Act). 
SEC. 7. ADDITIONAL ELIGIBILITY REQUIREMENTS FOR 
GRANTS TO STATES TO PREVENT CHILD 
ABUSE AND NEGLECT AT RESIDENTIAL PRO-
GRAMS. 
(a) IN GENERAL.—Title I of the Child Abuse Preven-
tion and Treatment Act (42 U.S.C. 5101 et seq.) is 
amended by adding at the end the following new section: 
‘‘SEC. 114. ADDITIONAL ELIGIBILITY REQUIREMENTS FOR 
GRANTS TO STATES TO PREVENT CHILD 
ABUSE AND NEGLECT AT RESIDENTIAL PRO-
GRAMS. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) CHILD.—The term ‘child’ means an indi-
vidual who has not attained the age of 18. 
‘‘(2) COVERED PROGRAM.— 
‘‘(A) IN
GENERAL.—The term ‘covered 
program’ means each location of a program op-
erated by a public or private entity that, with 
respect to one or more children who are unre-
lated to the owner or operator of the program— 
‘‘(i) provides a residential environ-
ment, such as— 
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‘‘(I) a program with a wilderness 
or outdoor experience, expedition, or 
intervention; 
‘‘(II) a boot camp experience or 
other experience designed to simulate 
characteristics of basic military train-
ing or correctional regimes; 
‘‘(III) a therapeutic boarding 
school; or 
‘‘(IV) a behavioral modification 
program; and 
‘‘(ii) operates with a focus on serving 
children with— 
‘‘(I) emotional, behavioral, or 
mental health problems or disorders; 
or 
‘‘(II) problems with alcohol or 
substance abuse. 
‘‘(B) EXCLUSION.—The term ‘covered pro-
gram’ does not include— 
‘‘(i) a hospital licensed by the State; 
or 
‘‘(ii) a foster family home that pro-
vides 24-hour substitute care for children 
place away from their parents or guardians 
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and for whom the State child welfare serv-
ices agency has placement and care respon-
sibility and that is licensed and regulated 
by the State as a foster family home. 
‘‘(3) PROTECTION AND ADVOCACY SYSTEM.— 
The term ‘protection and advocacy system’ means a 
protection and advocacy system established under 
section 143 of the Developmental Disabilities Assist-
ance and Bill of Rights Act of 2000 (42 U.S.C. 
15043). 
‘‘(b) ELIGIBILITY REQUIREMENTS.—To be eligible to 
receive a grant under section 106, a State shall— 
‘‘(1) not later than three years after the date 
of the enactment of this section, develop policies and 
procedures to prevent child abuse and neglect at cov-
ered programs operating in such State, including 
having in effect health and safety licensing require-
ments applicable to and necessary for the operation 
of each location of such covered programs that in-
clude, at a minimum— 
‘‘(A) standards that meet or exceed the 
standards required under section 3(a)(1) of the 
Stop Child Abuse in Residential Programs for 
Teens Act of 2009; 
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‘‘(A) an investigation not later than 60 
days after receipt by the Secretary of a report 
from a State, or a subdivision thereof, of child 
abuse and neglect at a covered program oper-
ating in the State, and submission of findings 
to appropriate law enforcement or other local 
entity where necessary, if the report indicates— 
‘‘(i) a child fatality at such program; 
or 
‘‘(ii) there is evidence of a pattern of 
violations of the standards required under 
subsection (b)(1) at such program or by an 
owner or operator of such program; 
‘‘(B) an annual review by the Secretary of 
cases of reports of child abuse and neglect in-
vestigated at covered programs operating in the 
State to assess the State’s performance with re-
spect to the appropriateness of response to and 
investigation of reports of child abuse and ne-
glect at covered programs and the appropriate-
ness of legal actions taken against responsible 
parties in such cases; and 
‘‘(C) unannounced site inspections of cov-
ered programs operating in the State to mon-
itor compliance with the standards required 
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