STRONG Support for Children Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 3792 To amend the Public Health Service Act to support the development and implementation of programs using data analysis to identify and facilitate strategies to improve outcomes for children in geographic areas with a high prevalence of trauma from exposure to adverse childhood experi- ences, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JUNE 8, 2021 Ms. PRESSLEY (for herself, Mrs. CAROLYN B. MALONEY of New York, Ms. NORTON, Mrs. HAYES, Mr. COOPER, Mr. VEASEY, Mr. RASKIN, Ms. BUSH, and Ms. OCASIO-CORTEZ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to support the development and implementation of programs using data analysis to identify and facilitate strategies to improve outcomes for children in geographic areas with a high prevalence of trauma from exposure to adverse childhood experiences, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Services and Trauma- 4 informed Research of Outcomes in Neighborhoods Grants 5 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 2 •HR 3792 IH for Support for Children Act of 2021’’ or the ‘‘STRONG 1 Support for Children Act of 2021’’. 2 SEC. 2. FINDINGS. 3 Congress finds that— 4 (1) childhood trauma is a pervasive public 5 health issue with long-term negative effects that 6 costs the United States thousands of lives and bil- 7 lions of dollars; 8 (2) addressing childhood and adolescent trauma 9 requires a comprehensive Federal approach that rec- 10 ognizes its severe impact and prioritizes trauma-in- 11 formed prevention and treatment that is reparative, 12 healing-centered, gender-responsive, culturally spe- 13 cific, and community-based; 14 (3) adults who have suffered from adverse 15 childhood experiences are at much greater risk of 16 death, including as the result of heart disease, lung 17 disease, cancer, substance use disorder, and suicide; 18 (4) childhood and adolescent exposures to ad- 19 verse childhood experiences are generational and 20 persistent and can lead to complex trauma and toxic 21 stress impacting brain development and triggering 22 epigenetics; 23 (5) any Federal effort to prevent and treat 24 trauma must acknowledge and address the impact of 25 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 3 •HR 3792 IH historic and systemic causal factors, which include, 1 but are not limited to, the trauma of— 2 (A) historical and ongoing systemic racism, 3 sexism, xenophobia, homophobia, transphobia, 4 and ableism that have led to generations of vio- 5 lence and injustice and have robbed commu- 6 nities of their health, freedom, and peace of 7 mind; 8 (B) police brutality, racial profiling, and 9 criminalization, as well as heightened police ac- 10 tivity and surveillance in some areas with high- 11 er police-reported crime, whether as a result of 12 community violence or of racial profiling; 13 (C) poverty and other systemic inequities, 14 including lack of health care, housing insta- 15 bility, poor housing conditions, hunger and food 16 instability and the accompanying malnutrition, 17 and environmental injustice resulting from gen- 18 erations of racist policies, historic redlining, 19 lending discrimination, and workplace discrimi- 20 nation; 21 (D) gender-based violence, including sexual 22 harassment and assault and discriminatory 23 school discipline policies, especially for Black 24 girls and girls of color; 25 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 4 •HR 3792 IH (E) western colonization and systemic di- 1 vestment in native communities; 2 (F) family separation policies, including 3 ‘‘zero-tolerance’’ immigration enforcement poli- 4 cies that have resulted in the deportation or the 5 threat of deportation for countless immigrant 6 families and have led to community mistrust 7 and fear of reporting injustices; and 8 (G) war and military presence, including 9 the increased militarization of local, State, and 10 Federal law enforcement agencies; and 11 (6) the COVID–19 global health pandemic has 12 increased and exacerbated the trauma inflicted on 13 young people, specifically young people who— 14 (A) live in communities with higher rates 15 of infection and mortality; 16 (B) have parents who are essential workers 17 or first responders; 18 (C) have parents who have lost their 19 sources of income; 20 (D) have witnessed death; 21 (E) have had their education interrupted; 22 (F) are living without access to green 23 space and space for physical exercise; 24 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 5 •HR 3792 IH (G) have become housing insecure and lack 1 access to nutritious food; and 2 (H) are isolated amidst increased domestic 3 violence and sexual assault. 4 SEC. 3. DATA ANALYSIS AND STRATEGY IMPLEMENTATION 5 TO PREVENT AND MITIGATE CHILDHOOD 6 TRAUMA. 7 Title XXXI of the Public Health Service Act (42 8 U.S.C. 300kk) is amended by adding at the end the fol- 9 lowing: 10 ‘‘SEC. 3102. DATA ANALYSIS AND STRATEGY IMPLEMENTA- 11 TION TO PREVENT AND MITIGATE CHILD- 12 HOOD TRAUMA. 13 ‘‘(a) IN GENERAL.—The Secretary shall establish a 14 program— 15 ‘‘(1) to support the development and implemen- 16 tation of programs that use data analysis methods 17 to identify and facilitate strategies for early inter- 18 vention and prevention, in order to prevent and miti- 19 gate childhood trauma and support communities and 20 families, including— 21 ‘‘(A) improving connections through care 22 coordination; 23 ‘‘(B) aligning community initiatives in tar- 24 geted areas of need; and 25 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 6 •HR 3792 IH ‘‘(C) expanding community capacity 1 through cross-sector collaboration; and 2 ‘‘(2) to evaluate the effectiveness of these pro- 3 grams in improving outcomes for children. 4 ‘‘(b) GRANTS.—The Secretary shall award grants to 5 up to 5 eligible entities to carry out the activities described 6 in subsection (a). 7 ‘‘(c) USE OF FUNDS.—A grant for activities under 8 this section shall be used to support the development and 9 implementation of programs that use data analysis meth- 10 ods to identify and facilitate strategies for early interven- 11 tion and prevention, in order to prevent and mitigate 12 childhood trauma and support communities and families, 13 including as follows: 14 ‘‘(1) Utilize data analysis methods to— 15 ‘‘(A) identify specific geographic areas, 16 such as census tracts, with a high prevalence of 17 adverse childhood experiences and significant 18 risk factors for poor outcomes for children 19 (such as increased risk of experiencing adverse 20 childhood experiences), including areas with 21 high rates of— 22 ‘‘(i) poor public health outcomes in- 23 cluding illness, disease, suicide, and mor- 24 tality; 25 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 7 •HR 3792 IH ‘‘(ii) exclusionary discipline practices, 1 including suspensions, expulsions, and re- 2 ferrals to law enforcement, as well as low 3 graduation rates; 4 ‘‘(iii) substance use disorders; 5 ‘‘(iv) poverty; 6 ‘‘(v) foster system involvement or re- 7 ferrals; 8 ‘‘(vi) housing instability and homeless- 9 ness; 10 ‘‘(vii) food insecurity; 11 ‘‘(viii) inequity, including disparities 12 in income, wealth, employment, educational 13 attainment, health care access, and public 14 health outcomes, along lines of race, sex, 15 sexuality and gender identity, ethnicity, or 16 nationality; 17 ‘‘(ix) incarceration rates; or 18 ‘‘(x) other indicators of adversity as 19 defined by the Secretary; and 20 ‘‘(B) identify strategies to improve out- 21 comes for children aged 0 through 17 that build 22 on strengths in communities that could be fur- 23 ther supported, including— 24 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 8 •HR 3792 IH ‘‘(i) existing support networks for 1 families; and 2 ‘‘(ii) enhanced connections to commu- 3 nity-based organizations. 4 ‘‘(2) Implement strategies identified pursuant 5 to paragraph (1)(B) to facilitate outreach and in- 6 volvement of children and their caregivers in Fed- 7 eral, State, or local programs that provide repar- 8 ative, gender-responsive, culturally specific, and 9 trauma-informed prevention services, and for which 10 children and their caregivers are eligible, including— 11 ‘‘(A) home visiting programs; 12 ‘‘(B) training and education on parenting 13 skills; 14 ‘‘(C) substance use disorder prevention and 15 treatment that is voluntary and noncoercive; 16 ‘‘(D) mental health supports and care that 17 is voluntary and noncoercive; 18 ‘‘(E) family and intimate partner violence 19 prevention services; 20 ‘‘(F) child advocacy center programming; 21 ‘‘(G) economic and nutrition support serv- 22 ices; 23 ‘‘(H) housing support services, including 24 emergency and temporary shelter for those ex- 25 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 9 •HR 3792 IH periencing homelessness and housing insecurity, 1 as well as stable, long-term housing; 2 ‘‘(I) voluntary, noncoercive, gender-respon- 3 sive, and culturally specific mental health sup- 4 ports in school and early childhood education 5 center-based settings; 6 ‘‘(J) wraparound programs for 7 transitioning youth and youth currently in the 8 foster system; 9 ‘‘(K) programming to support the health 10 and well-being of lesbian, gay, bisexual, 11 transgender, and intersex children and their 12 families; and 13 ‘‘(L) family resource center services. 14 ‘‘(d) SPECIAL RULES.— 15 ‘‘(1) PRIMARY PAYER RESTRICTION.—The Sec- 16 retary may not award a grant under this section to 17 an eligible entity for a service if the service to be 18 provided is available pursuant to the State plan ap- 19 proved under title XIX of the Social Security Act for 20 the State in which the program funded by the grant 21 is being conducted unless the State and all eligible 22 subdivisions involved— 23 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 10 •HR 3792 IH ‘‘(A) will enter into agreements with public 1 or nonprofit private entities under which the 2 entities will provide the service; and 3 ‘‘(B) demonstrate that the State and all el- 4 igible subdivisions will ensure that the entities 5 providing the service— 6 ‘‘(i) will seek payment for each such 7 service rendered in accordance with the 8 usual payment schedule under the State 9 plan; and 10 ‘‘(ii) the entities have entered into a 11 participation agreement and are qualified 12 to receive payments under such plan. 13 ‘‘(2) IMPLEMENTATION.—An eligible entity that 14 receives a grant under this section may use— 15 ‘‘(A) not more than 25 percent of the 16 amounts made available through the grant for 17 the first 24 months of the grant period to uti- 18 lize data analysis methods to— 19 ‘‘(i) identify specific geographic areas 20 where care coordination, prevention and 21 early intervention, and facilitation services 22 will be provided; and 23 ‘‘(ii) identify support and intervention 24 services to improve outcomes for children 25 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 11 •HR 3792 IH located in a geographic area identified 1 under subsection (c)(1)(A); and 2 ‘‘(B) not more than 10 percent of the 3 grant in each subsequent year to continue data 4 analysis activities. 5 ‘‘(3) ADMINISTRATION.—An eligible entity that 6 receives a grant under this section may not use more 7 than 5 percent of amounts received through the 8 grant for administration, reporting, and program 9 oversight functions, including the development of 10 systems to improve data collection and data sharing 11 for the purposes of improving services and the provi- 12 sion of care. 13 ‘‘(4) PRIORITY.— 14 ‘‘(A) IN GENERAL.—In awarding grants 15 under this section, the Secretary shall give pri- 16 ority, to the extent practical, to eligible entities 17 that use community-based system dynamic 18 modeling as the primary data analysis method. 19 ‘‘(B) SYSTEM DYNAMIC MODELING DE- 20 FINED.—The term ‘system dynamic modeling’ 21 means a method of data analysis and predictive 22 modeling that includes— 23 ‘‘(i) utilization of community-based 24 participatory research methods for involv- 25 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 12 •HR 3792 IH ing community in the process of under- 1 standing and changing systems and evalu- 2 ating outcomes of grants; 3 ‘‘(ii) consideration of a multitude of 4 environmental risk factors and ascertain- 5 ment of the significance of contributing 6 community risk factors for purposes of 7 identifying strategies to reduce adverse 8 child outcomes, including— 9 ‘‘(I) maltreatment cases; 10 ‘‘(II) involvement with the juve- 11 nile criminal legal system or foster 12 system; 13 ‘‘(III) exclusionary school dis- 14 cipline; or 15 ‘‘(IV) exposure to violence; and 16 ‘‘(iii) identification of cross-sector re- 17 sponses involving reparative, trauma-in- 18 formed, culturally specific, gender-respon- 19 sive, and community-based organizations 20 to reduce adverse child outcomes. 21 ‘‘(5) SUBGRANT.— 22 ‘‘(A) IN GENERAL.—An eligible entity that 23 receives a grant under this section shall use at 24 least 25 percent of the total amount of the 25 VerDate Sep 11 2014 17:18 Jun 29, 2021 Jkt 019200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.IH H3792 lotter on DSK11XQN23PROD with BILLS 13 •HR 3792 IH grant to make subgrants to organizations that 1 aide in implementing the strategy identified 2 under subsection (c)(1)(B) for preventing and 3 mitigating childhood trauma and supporting 4 communities and families. 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