II 118th CONGRESS 1st Session S. 3333 IN THE SENATE OF THE UNITED STATES November 15, 2023 Ms. Klobuchar (for herself and Mr. Cramer ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To enhance pre- and post-adoption support services, and for other purposes.

1. Short title This Act may be cited as the Supporting Adopted Children and Families Act . 2. Adoption support services (a) Ensuring the well-Being of adopted children and their adoptive families Section 421 of the Social Security Act ( 42 U.S.C. 621 ) is amended— (1) in paragraph (4), by striking and at the end; (2) by redesignating paragraph (5) as paragraph (6); and (3) by inserting after paragraph (4) the following new paragraph: (5) ensuring the well-being of adopted children and their adoptive families and promoting efforts to prevent such children from entering the foster care system through the provision of pre- and post-adoption support services; and . (b) Pre- and post-Adoption support services Paragraph (8) of section 431(a) of such Act ( 42 U.S.C. 629a(a) ) is amended to read as follows: (8) Adoption promotion and support services (A) In general The term adoption promotion and support services means services and activities designed to encourage more adoptions out of the foster care system and support domestic adoptions and adoptions from other countries, consistent with promoting the best interests of adopted children and their adoptive families. Such services and activities may include pre- and post-adoption support services, as described in subparagraph (B), that are designed to support adopted children and their adoptive families. (B) Pre- and post-adoption support services The term pre- and post-adoption support services means the following: (i) Pre-adoption support services, which may include— (I) direct services, including training, educational support, counseling, and other services for adoptive parents and families that address caregiver interests and concerns regarding common behavioral issues, such as— (aa) issues relating to emotional, behavioral, or developmental health needs; (bb) issues relating to attachment, identity, abandonment, cultural differences, grief, loss, and trauma; and (cc) issues resulting from birth defects due to fetal alcohol syndrome or any other substance abuse-related developmental disorder; (II) the provision of educational resources for adoptive parents regarding the geographic, ethnic, and cultural background of the adopted child; (III) peer-to-peer mentoring and support groups that permit a newly adoptive parent to communicate and learn from more experienced adoptive parents, including programs that enhance communication between adoptive parents with children of similar geographic, ethnic, or cultural backgrounds; and (IV) the provision of informational resources for adoptive parents, including— (aa) resources available through Federal and State agencies, including information regarding benefits for children with a medical condition or a physical, mental, or emotional disability; (bb) newsletters, websites, and other informational resources regarding adoption-related services; (cc) the establishment of lending libraries containing information and resources for adoptive parents; and (dd) conferences, discussion groups, and seminars that are available to adoptive parents and other relevant stakeholders. (ii) Post-adoption support services, which may include— (I) continued provision to adoptive parents of pre-adoption support services described in clause (i); (II) the provision of accessible and reliable respite services for adoptive parents; (III) direct services and counseling for adopted children, including, as appropriate— (aa) support services for an adopted child with emotional, behavioral, or developmental health needs; (bb) support services that address issues relating to attachment, identity, abandonment, cultural differences, grief, and loss; and (cc) treatment services that are specialized for adopted children, including psychiatric residential services, outpatient mental health services, social skills training, intensive in-home supervision services, recreational therapy, suicide prevention, and substance abuse treatment; (IV) peer-to-peer mentoring and support groups that allow adopted children to communicate and socialize with other adopted children, including programs that provide for communication between adopted children from similar geographic, ethnic, or cultural backgrounds; and (V) crisis and family preservation services, including crisis counseling and a 24-hour emergency hotline for adoptive parents. . 3. Funding for adoption promotion and support services Paragraph (8) of section 473(a) of the Social Security Act ( 42 U.S.C. 673(a) ) is amended to read as follows: (8) With respect to the amount of savings (if any) in State expenditures under this part resulting from the application of paragraph (2)(A)(ii) to all applicable children for a fiscal year, a State shall— (A) spend a significant portion of such amount to provide pre- and post-adoption support services (as defined in section 431(a)(8)(B)); (B) spend the remainder of such amount to provide to children or families any other services that may be provided under this part or part B; and (C) on an annual basis, submit to the Secretary a report that provides a detailed account of any services that were funded pursuant to this paragraph. . 4. Federal grant program for post-adoption and post-legal guardianship mental health services (a) Funding Section 436 of the Social Security Act ( 42 U.S.C. 629f ) is amended— (1) in subsection (a), by striking $345,000,000 for each of fiscal years 2017 through 2023 and inserting $365,000,000 for each of fiscal years 2024 through 2028 ; and (2) in subsection (b), by adding at the end the following new paragraph: (6) Post-adoption and post-legal guardianship mental health services The Secretary shall reserve $20,000,000 for grants under section 437(h). . (b) Grant program Section 437 of the Social Security Act ( 42 U.S.C. 629g ) is amended by adding at the end the following new subsection: (h) Post-Adoption and post-Legal guardianship mental health service programs (1) In general From the amounts reserved for each of fiscal years 2024 through 2028 under section 436(b)(6), the Secretary shall award grants or cooperative agreements under this subsection to eligible entities to— (A) develop and implement statewide or tribal post-adoption and post-legal guardianship mental health service programs for all children who are adopted or placed in legal guardianship and their families; (B) support public organizations and private nonprofit organizations actively involved in statewide or tribal post-adoption and post-legal guardianship mental health service programs; (C) collect and analyze data on State-sponsored statewide or tribal post-adoption and post-legal guardianship mental health service programs that can be used to monitor the effectiveness of such services and for research, technical assistance, and policy development; (D) develop and provide adoption and legal guardianship competent educational and training opportunities concerning the mental health needs of children who are adopted or placed in legal guardianship, and their families, for use by teachers, social workers, and other community mental health service providers; (E) develop and provide materials for potential adoptive parents and legal guardians, both for children who already reside in the United States at the time of adoption or placement in legal guardianship and for those who at such time reside in other countries, describing the possible need for post-adoption and post-legal guardianship mental health services and available resources; (F) develop and provide respite care services for adoptive and legal guardian families; and (G) support research on, and development of, promising practices (as defined in section 471(e)(4)(C)(iii)) for post-adoption and post-legal guardianship mental health services. (2) Eligible entity defined (A) In general In this subsection, the term eligible entity means— (i) a State; (ii) a public organization or private nonprofit organization designated by a State to develop or direct the State-sponsored statewide post-adoption and post-legal guardianship mental health service program under a grant under this subsection; and (iii) a federally recognized Indian tribe or tribal organization (as defined in the Indian Self-Determination and Education Assistance Act) or an urban Indian organization (as defined in the Indian Health Care Improvement Act) that is actively involved in the development and continuation of a post-adoption and post-legal guardianship mental health service program. (B) Limitation In carrying out this subsection, the Secretary shall ensure that each State is awarded only 1 grant or cooperative agreement under this subsection. For purposes of the preceding sentence, a State shall be considered to have been awarded a grant or cooperative agreement if the eligible entity involved is the State or an entity designated by the State under subparagraph (A)(ii). Nothing in this subparagraph shall be construed to apply to entities described in subparagraph (A)(iii). (3) Preference In providing assistance under a grant or cooperative agreement under this subsection, the Secretary shall give preference to— (A) eligible entities that have demonstrated success in increasing the level of adoption and legal guardianship competency among mental health providers, adoption and legal guardianship lawyers, social workers, case workers, adoptive parents, and legal guardians; and (B) eligible entities that plan to partner with their State mental health agency in carrying out the activities for which the grant or cooperative agreement is made. (4) Requirement for direct services Not less than 85 percent of funds received under a grant or cooperative agreement under this subsection shall be used to provide direct services, of which not less than 5 percent shall be used for activities authorized under paragraph (1)(C). (5) Coordination and collaboration (A) In general In carrying out this subsection, the Secretary shall collaborate with relevant Federal agencies and adoption and legal guardianship-related working groups to promote interaction between domestic foster care agencies and private adoption agencies in other countries. (B) Consultation In carrying out this subsection, the Secretary shall consult with— (i) State and social service agencies engaged in the placement of children for adoption, domestically or from other countries; (ii) local and national organizations that serve foster and adopted youth and youth placed in legal guardianship; (iii) health and education specialists who focus on adoption, legal guardianship, and foster care medicine; (iv) youth who have been in foster care, adopted, or in legal guardianship, domestically or from other countries, including youth who have experienced adoption or guardianship disruptions or dissolutions; (v) families and friends of youth who have been in foster care, adopted, or in legal guardianship, domestically or from other countries, including foster and adoptive parents and legal guardians; and (vi) qualified professionals who possess the specialized knowledge, skills, experience, and relevant attributes needed to serve children who are adopted or placed in legal guardianship and their families. (C) Policy development In carrying out this subsection, the Secretary shall— (i) coordinate and collaborate on policy development with relevant Department of Health and Human Services agencies and adoption and legal guardianship-related working groups; and (ii) consult on policy development at the Federal level with those in the private sector engaged in the recruitment of foster and adoptive parents and legal guardians, the placement of children in foster care, for adoption, and in legal guardianship, and the provision of post-adoption and post-legal guardianship services. (6) Evaluation and report (A) Evaluations by eligible entities Not later than 18 months after receipt of a grant or cooperative agreement under this subsection, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement. (B) Report Not later than 2 years after the date of enactment of this subsection, the Secretary shall submit to the appropriate committees of Congress a report concerning the results of— (i) the evaluations conducted under subparagraph (A); and (ii) an evaluation conducted by the Secretary to analyze the effectiveness and efficacy of the activities conducted with grants, collaborations, and consultations under this subsection. (7) Additional definitions In this subsection: (A) Adopted child The term adopted child means an individual who is under 21 years of age and was adopted from foster care or placed in legal guardianship through a private placement agency, or from another country. (B) Adoption and legal guardianship competency The term adoption and legal guardianship competency means an understanding of— (i) the nature of adoption and legal guardianship as a form of family formation and the different types of adoption and legal guardianship; (ii) relevant emotional and physical issues involved in the adoption or legal guardianship process, including issues relating to separation, loss, attachment, abuse, trauma, and neglect; (iii) common developmental challenges associated with adoption and legal guardianship; (iv) the characteristics and skills that allow for successful adoptive and legal guardianship families; (v) proper sensitivity with respect to the different geographic, ethnic, or cultural backgrounds of children who are adopted or placed in legal guardianship and their families; and (vi) the necessary skills for effectively advocating on behalf of birth and adoptive and legal guardian families. (C) Post-adoption and post-legal guardianship mental health services The term post-adoption and post-legal guardianship mental health services includes— (i) adoption and legal guardianship competent mental health direct services, including training, educational support, counseling, and other services for adoptive and legal guardian parents and families that address caregiver interests and concerns regarding child behavioral issues that are common among children who are adopted, placed in legal guardianship, or placed in foster care, including, as appropriate— (I) caring for a child who is adopted or placed in legal guardianship and has emotional, behavioral, or developmental health needs; and (II) providing for the emotional needs of a child who is adopted or placed in legal guardianship, including issues relating to attachment, identity, abandonment, cultural differences, grief, loss, and trauma; (ii) peer-to-peer mentoring and support groups that permit a newly adoptive parent or legal guardian to communicate and learn from more experienced adoptive parents or legal guardians; (iii) the provision of informational resources and available services for adoptive parents or legal guardians; (iv) direct services, including counseling, peer-to-peer mentoring and support groups, and other services for children who are adopted or placed in legal guardianship that address common behavioral and adjustment issues, including, as appropriate— (I) support services for a child who is adopted or placed in legal guardianship with emotional, behavioral, or developmental health needs; (II) support services that address the emotional needs of a child who is adopted or placed in legal guardianship, including issues relating to attachment, identity, abandonment, cultural differences, grief, loss, and trauma; and (III) treatment services that are specialized for children who are adopted or placed in legal guardianship, including psychiatric residential services, outpatient mental health services, social skills training, intensive in-home supervision services, recreational therapy, suicide prevention, and substance abuse treatment; (v) peer-to-peer mentoring and support groups that allow children who are adopted or placed in legal guardianship communicate and socialize with other such children; and (vi) crisis intervention and family preservation services. . 5. Data collection on Adoption Disruption and Dissolution (a) In general Section 479 of the Social Security Act ( 42 U.S.C. 679 ) is amended by adding at the end the following new subsection: (e) (1) Not later than 12 months after the date of enactment of the Supporting Adopted Children and Families Act , the Secretary shall, as part of the data collection system established under this section, promulgate final regulations providing for the collection and analysis of information regarding children who enter into State custody as a result of the disruption of a placement for adoption or the dissolution of an adoption, which shall require States to collect and report— (A) information on children who are adopted within the United States or from other countries and who enter into State custody as a result of the disruption of a placement for adoption or the dissolution of an adoption, including— (i) the number of children who enter into State custody as a result of— (I) the disruption of placement for adoption; or (II) the dissolution of an adoption; and (ii) for each child identified under clause (i)— (I) as applicable, the country of birth for any child who was not born in the United States; (II) the length of the adoption placement prior to disruption or dissolution; (III) the age of the child at the time of the disruption or dissolution; (IV) the reason for the disruption or dissolution; and (V) the agencies who handled the placement for adoption; and (B) such other information as determined appropriate by the Secretary. (2) The information described in paragraph (1) shall be used— (A) to consolidate and expand the collection of information on adoption disruption and dissolution; (B) to improve research and data collection systems in order to more accurately determine and measure the rates, outcomes, and causes of adoption disruption and dissolution; (C) to identify pre- and post-adoption support services (including services described in section 431(a)(8)(B)) that result in lower rates of disruption and dissolution of adoptions; (D) to develop an understanding of the relationship between the rate of incidence of adoption disruptions and dissolutions and the support services that are provided to adoptive families in order to identify and develop effective evidence-based strategies, programs, and support services that help to prevent adoption disruption and dissolution; and (E) to develop and enhance training and educational services regarding strategies for prevention of adoption disruption and dissolution. (3) (A) Not later than 6 months after the date of enactment of the Supporting Adopted Children and Families Act , the Secretary shall, subject to subparagraph (B), establish an advisory committee to study methods to effectively collect data regarding disruption and dissolution of adoptions that are not included in the data collection system established under this section, including— (i) data on children whose adoptions are disrupted or dissolved but do not enter into State custody as a result of such disruption or dissolution; (ii) data on adoption displacements, whereby an adopted child is temporarily placed out of the home of an adoptive parent in order to receive medical, mental health, behavioral, or other forms of treatment; and (iii) such other data as determined appropriate by the Secretary. (B) The membership and organization of the advisory committee described in subparagraph (A) shall be determined by the Secretary and shall include— (i) State and child welfare agencies that are engaged in the placement of children for adoption domestically or from other countries; (ii) local and national organizations that serve adopted children and children in foster care; and (iii) members of State and local judiciary and court staff. (C) Not later than 12 months after establishment of the advisory committee described in subparagraph (A), the Secretary shall submit to the appropriate committees of Congress a report containing recommendations of the advisory committee for improvement of the data collection system established under this section. . (b) Annual report Section 479A(a) of the Social Security Act ( 42 U.S.C. 679b(a) ) is amended— (1) in paragraph (6)(C), by striking and after the semicolon; (2) in paragraph (7), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following new paragraph: (8) include in the report submitted pursuant to paragraph (5) for fiscal year 2024 or any succeeding fiscal year, national and State-by-State data on the numbers and rates of disruptions and dissolutions of adoptions, as collected pursuant to section 479(e)(1). .