,,ii #aacth ,,congress #ast ,session ,s4 #chj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #bf1 #bjac ,mrs4 ,murray introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to reauthorize and update the ,national ,child ,traumatic ,stress ,initiative for grants to address the problems of individuals who experience trauma and violence related stress4 #a4 ,short title ,this ,act may be cited as the ,children's ,recovery from ,trauma ,act4 #b4 ,findings ,congress makes the following findings3 7#a7 ,according to a #bjjb ,government ,accountability ,office report 7,,gao-#jb-hac71 large numbers of children experience trauma-related mental health problems1 while at the same time facing barriers to receiving appropriate mental health care4 7#b7 ,according to the ,national ,institute of ,mental ,health1 only #cf percent of youth with any mental disorder received services1 and only half of these youth who were severely impaired by their mental disorder received any professional mental health treatment4 ,of those with anxiety disorders 7including post traumatic stress disorder71 only #ah percent received services4 ,half of all lifetime cases of mental illness begin by age #ad1 and that despite effective treatments that have been developed1 there are long delays1 sometimes decades1 between first onset of symptoms and when treatment is obtained4 7#c7 ,findings from the ,adverse ,childhood ,experiences ,study have shown that adverse childhood experiences predispose children towards negative trajectories from infancy to adulthood4 7#d7 ,the ,great ,smoky ,mountains ,study1 a representative longitudinal study of children1 found that by age #af1 more than #fg percent of the children had been exposed to one or more traumatic events1 such as child maltreatment1 domestic violence1 or sexual assault 7,copeland et al1 #bjjg74 7#e7 ,according to the ,national ,institute of ,mental ,health1 the lifetime prevalence of post-traumatic stress disorder for #ac to #ah year olds is #d to #f percent 7,,nimh1 #bjaj74 ,in #bjjg1 the ,national ,institute of ,mental ,health reported that adults who were abused or neglected as children have increased risk of major depression1 often beginning in childhood with long-lasting effects4 7#f7 ,according to the ,department of ,defense1 more than #gjj1jjj children have experienced one or more parental deployments4 ,children's reactions to a parent's deployment vary by a child's developmental stage1 age1 and presence of any preexisting psychological or behavioral problems4 ,the mental health of the parent is often a key factor affecting the child's distress level4 ,parents reporting clinically significant stress are more likely to have children identified as high risk for psychological and behavioral problems4 7#g7 ,the ,national ,intimate ,partner and ,sexual ,violence ,survey revealed that nearly #a in #e women reported having been the victim of a rape at some time during their lives4 ,forty-two percent experienced their first rape before the age of #ah4 7#h7 ,the ,national ,child ,traumatic ,stress ,network collected data on #ad1jhh children and adolescents served by #ef ,network service centers across the country from #bjjd to #bjaj1 examining the prevalence of exposure to a wide range of trauma types1 access to services1 and child outcomes outcome4 ,nearly #hj percent of children referred for screening and evaluation reported experiencing at least one type of traumatic event4 ,of the #aa1ajd children and adolescents who reported trauma exposure1 #gg percent had experienced more than one type of trauma and #ca percent had experienced five or more types4 7#i7 ,the children served by the ,national ,child ,traumatic ,stress ,network are involved with many different kinds of child-serving systems4 ,of those receiving service1 #fe percent had received social services and #ce percent had received school-based services4 ,after treatment1 significant improvements were made in trauma symptoms1 mental health diagnoses1 and behavioral problems4 #c4 ,grants to address the problems of individuals who experience trauma and violence related stress ,section #ehb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh-#a7 is amended to read as follows3 #ehb4 ,grants to address the problems of individuals who experience trauma and violence related stress 7a7 ,in general ,the ,secretary shall award grants1 contracts or cooperative agreements to public and nonprofit private entities1 as well as to ,indian tribes and tribal organizations1 for the purpose of developing and maintaining programs that provide for-- 7#a7 the continued operation of the ,national ,child ,traumatic ,stress ,initiative 7referred to in this section as the ,,nctsi7 that focus on the mental1 behavioral1 and biological aspects of psychological trauma response2 and 7#b7 the development of knowledge with regard to evidence-based practices for identifying and treating mental1 behavioral1 and biological disorders of children and youth resulting from witnessing or experiencing a traumatic event4 7b7 ,priorities ,in awarding grants1 contracts or cooperative agreements under subsection 7a77#b7 7related to the development of knowledge on evidence-based practices for treating mental1 behavioral1 and biological disorders associated with psychological trauma71 the ,secretary shall give priority to universities1 hospitals1 mental health agencies1 and other community-based child-serving programs that have established clinical and research experience in the field of trauma-related mental disorders4 7c7 ,child outcome data ,the ,,nctsi coordinating center shall collect1 analyze1 and report ,,nctsi-wide child outcome and process data for the purpose of establishing the effectiveness1 implementation1 and clinical utility of early identification and delivery of evidence-based treatment and services delivered to children and families served by the ,,nctsi grantees4 7d7 ,training ,the ,,nctsi coordinating center shall oversee the continuum of interprofessional training initiatives in evidence-based and trauma-informed treatments1 interventions1 and practices offered to ,,nctsi grantees and providers in all child-serving systems4 7e7 ,dissemination ,the ,,nctsi coordinating center shall collaborate with the ,secretary in the dissemination of evidence-based and trauma-informed interventions1 treatments1 products1 and other resources to all child-serving systems and policymakers4 7f7 ,review ,the ,secretary shall establish consensus-driven1 in-person or teleconference review of ,,nctsi applications by child trauma experts and review criteria related to expertise and experience related to child trauma and evidence-based practices4 7g7 ,geographical distribution ,the ,secretary shall ensure that grants1 contracts or cooperative agreements under subsection 7a7 are distributed equitably among the regions of the ,united ,states and among urban and rural areas4 ,notwithstanding the previous sentence1 expertise and experience in the field of trauma-related disorders shall be prioritized in the awarding of such grants are required under subsection 7b74 7h7 ,evaluation ,the ,secretary1 as part of the application process1 shall require that each applicant for a grant1 contract or cooperative agreement under subsection 7a7 submit a plan for the rigorous evaluation of the activities funded under the grant1 contract or agreement1 including both process and outcome evaluation1 and the submission of an evaluation at the end of the project period4 7i7 ,duration of awards ,with respect to a grant1 contract or cooperative agreement under subsection 7a71 the period during which payments under such an award will be made to the recipient shall be #f years4 ,such grants1 contracts or agreements may be renewed4 ,expertise and experience in the field of trauma-related disorders shall be a priority for new and continuing awards4 7j7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #ajj1jjj1jjj for fiscal year #bjad1 and such sums as may be necessary for each of fiscal years #bjae through #bjbd4 4