II 118th CONGRESS 1st Session S. 2836 IN THE SENATE OF THE UNITED STATES September 19, 2023 Mr. Casey introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend subpart 1 of part B of title IV of the Social Security Act to support the mental health and well-being of children and youth in, and formerly in, foster care, and for other purposes.

1. Short title This Act may be cited as the Foster Youth Mental Health Act of 2023 . 2. National navigation program to support the mental health and well-being of children and youth in, and formerly in, foster care Section 426 of the Social Security Act ( 42 U.S.C. 626 ) is amended— (1) in the section heading, by inserting special projects, after training, ; (2) in subsection (a)— (A) in paragraph (1)(C), by striking and after the semicolon; (B) in paragraph (2), by striking the period at the end and inserting ; and ; and (C) by inserting after paragraph (2), the following new paragraph: (3) for grants by the Secretary, or contracts or cooperative arrangements, for the operation of a national navigation program to support the mental health and well-being of children and youth in, and formerly in, foster care that includes a 24-hour text line and toll-free hotline by which children and youth in foster care, youth who are aging out of foster care, children and youth formerly in foster care who have not yet reached their 28th birthday, foster and adoptive parents, kinship guardians, and parents of children in foster care may request information on support for foster and adopted youth mental health and well-being that is staffed by youth who were formerly in foster care and individuals with expertise in helping such populations navigate and access resources to support their mental health and well-being, including with respect to mental health and substance use disorder treatments and services, insurance coverage and renewal, housing, childcare, skills training and education, extracurricular activities, and other critical services for children and youth in foster care and youth who are aging out of foster care. ; and (3) by adding at the end the following new subsection: (d) National navigation program To support the mental health and well-Being of children in, and formerly in, foster care (1) Funding requirement Beginning with the first fiscal year after fiscal year 2023 for which the amount appropriated for the fiscal year to carry out this section exceeds the amount appropriated for such purpose for fiscal year 2023 by at least $5,000,000, the Secretary shall make grants, or enter into contracts or cooperative arrangements, to carry out the national navigation program to support the mental health and well-being of children in, and formerly in, foster care in accordance with subsection (a)(3). (2) Utilization The Secretary shall evaluate the demographics of the children and parents who use or request information from the national navigation program carried out in accordance with subsection (a)(3) and shall identify the demographics of children and parents who are not accessing the program and increase outreach to make such children and parents aware of the program. . 3. Comprehensive mental health systems to support the mental health and well-being of foster care youth Section 422(b)(15) of the Social Security Act ( 42 U.S.C. 622(b)(15) ) is amended— (1) in subparagraph (A)— (A) in the matter preceding clause (i), by striking provides and inserting provide ; and (B) in clause (viii), by striking and after the semicolon; (2) by redesignating subparagraph (B) as subparagraph (C); (3) in subparagraph (C) (as redesignated by paragraph (2) of this section), by striking subparagraph (A) and inserting subparagraphs (A) and (B) ; and (4) by inserting after subparagraph (A), the following new subparagraph: (B) contain assurances that not less than 10 percent of expenditures for services and activities the State will fund under the State program carried out pursuant to this subpart shall be for developing and providing ongoing support for a comprehensive mental health system for youth in a foster care placement that meets the requirements of subparagraph (A) and— (i) is established through partnerships with pediatricians, mental health professionals, child-serving agencies, child advocates, family groups, housing services, alternative programs that support mental health and well-being, and other key organizations to ensure youth in a foster care placement have timely access to non-pharmaceutical mental health and substance use disorder treatments and services; (ii) includes services and activities for youth in a foster care placement who are at risk of developing, or have, a mental health or substance use disorder, at the prevention, early intervention, and treatment stages; (iii) includes processes for— (I) recruiting, hiring, supervision, or training of individuals with lived experience to serve as peer specialists who deliver services to youth in a foster care placement as they navigate the child welfare system and other health and social services programs and who check in with such youth weekly; (II) training of caseworkers and other staff working within the child welfare system with a series of trauma-informed and addiction-based professional development training sessions to better connect youth with resources for treatment and services as they enter the child welfare system, including the therapeutic supports and community-based resources developed and implemented in accordance with subclause (III); and (III) the development and implementation of protocols for assisting youth in a foster care placement with accessing therapeutic supports, including navigation to peer support, family therapy, and alternative therapies such as music or art therapy, play therapy, sports, mobile or virtual therapy, as well as community-based resources, such as parenting classes, community-provided financial and in-kind material support, behavioral health care, and community engagement opportunities; (iv) has procedures to address privacy concerns which include requirements for private space to be made available for mental health sessions, requirements for the use of platforms with end-to-end encryption for the exchange of sensitive health information that comply with the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996, requirements for youth in a foster care placement to be informed of confidentiality agreements with counselors, therapists, and psychiatrists, and provided with information regarding where and how to file a grievance about each member of their care team, and requirements to retrain mental health, child welfare, or juvenile justice professionals who have violated such confidentiality agreements on upholding these requirements; and (v) requires that, in the case of a youth in a foster care placement who needs treatment for a mental health condition or substance use disorder— (I) the health and education information required for the youth's case plan under section 475(1)(C) includes documentation evidencing having discussed with the youth the youth's options for treatment of the mental health condition or substance use disorder and a plan for the delivery of such treatments, prior to, or as soon as practicable after, the start of treatment; (II) procedures are in place to ensure continuity of care for a youth in a foster care placement who is being treated for a mental health condition or substance use disorder if the youth is moved to another placement setting, the youth's treatment is transferred to another provider, or the type of treatment is changed; (III) the components of the transition plan development process required under section 475(5)(H) that relate to the health care needs of children aging out of foster care, includes a plan for continuity of care when a youth in a foster care placement who is being treated for a mental health condition or substance use disorder leaves foster care; and (IV) systems are in place to follow up with youth to ensure receipt and adequacy of needed mental health or substance use disorder services, with protocols to respond to concerns identified by foster youth and assist youth with accessing additional care as recommended by a health care professional; and . 4. Effective date (a) In general The amendments made by this Act shall take effect on the date of enactment of this Act and shall apply to payments under subpart 1 of part B of title IV of the Social Security Act for calendar quarters beginning on or after such date, and without regard to whether regulations to implement the amendments are promulgated by such date. (b) Exception for state plans requiring state law amendments In the case of a State plan under subpart 1 of part B of title IV of the Social Security Act which the Secretary determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by this Act, the effective date of the amendments imposing the additional requirements shall be 3 months after the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the preceding sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.