,,ii #aadth ,,congress #b;d ,session ,s4 #cjca ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #h1 #bjaf,mr4 ,murphy introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to require certain standards and enforcement provisions to prevent child abuse and neglect in residential programs1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,stop ,child ,abuse in ,residential ,programs for ,teens ,act of #bjaf4 #b4 ,definitions ,in this ,act3 7#a7 ,child ,the term child means an individual who has not attained the age of #ah4 7#b7 ,child abuse and neglect ,the term child abuse and neglect has the meaning given such term in section #c of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja note74 7#c7 ,covered program 7,a7 ,in general ,the term covered program means a program 7including the portion of a program at each affiliated facility7 that is operated by a public or private entity and that1 with respect to one or more children who are unrelated to the owner or operator of the program1 purports to provide treatment or modify behaviors in a residential environment1 such as-- 7i7 a program with a wilderness or outdoor experience1 expedition1 or intervention2 7ii7 a boot camp experience or other experience designed to simulate characteristics of basic military training or correctional regimes2 7iii7 a therapeutic boarding school2 or 7iv7 a behavioral modification program4 7,b7 ,exclusion ,the term covered program does not include-- 7i7 a hospital licensed by the ,state2 or 7ii7 a foster family home or foster group home that provides #bd-;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 responsibility and that is licensed and regulated by the ,state as a foster family home or foster group home4 7#d7 ,licensed clinician ,the term licensed clinician means such a clinician1 as defined by ,state law4 7#e7 ,mechanical restraint ,the term mechanical restraint has the meaning given the term in section #eie7;d77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;jj7d77#a774 7#f7 ,mental health practitioner ,the term mental health practitioner means such a practitioner1 as defined by ,state law4 7#g7 ,physical restraint ,the term physical restraint means a personal restriction on an individual that immobilizes or reduces the ability of the individual to move freely the individual's arms1 legs1 torso1 or head1 except that such term does not include voluntary physical escort 7as such term is defined in section #eie7;d77#b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;jj7d77#b7774 7#h7 ,protection and ,advocacy ,system ,the term protection and advocacy system means a system established by a ,state under section #adc of the ,developmental ,disabilities ,assistance and ,bill of ,rights ,act of #bjjj 7#db ,u4,s4,c4 #aejdc74 7#i7 ,seclusion ,the term seclusion means the involuntary confinement of a child alone in a room or area from which the child is physically prevented from leaving4 7#aj7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#aa7 ,staff member ,the term staff member includes a volunteer and an applicant to be a staff member4 7#ab7 ,state ,the term ,state has the meaning given such term in section #c of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja note74 #c4 ,standards and enforcement 7a7 ,minimum standards 7#a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall require each covered program in a ,state1 in order to provide for the basic health and safety of children at such a program and in order for the ,state to remain eligible as described in section #aad7;b7 of the ,child ,abuse ,prevention and ,treatment ,act 7as added by section #g of this ,act71 to meet the following minimum standards3 7,a7 ,prohibition on child abuse and neglect ,child abuse and neglect shall be prohibited4 7,b7 ,prohibition on certain disciplinary techniques ,disciplinary techniques or other practices that involve the withholding of essential food1 water1 clothing1 shelter1 or medical care necessary to maintain physical health1 mental health1 and general safety1 shall be prohibited4 7,c7 ,prohibition on physical or mental abuse ,acts of physical or mental abuse designed to humiliate or degrade a child1 or undermine a child's self-respect1 shall be prohibited4 7,d7 ,limitation on restraints and seclusion 7i7 ,certain restraints and seclusion ,the use of seclusion1 mechanical restraints1 and physical restraints that impair breathing or communication shall be prohibited4 7ii7 ,physical restraints in emergencies ,physical restraints other than the restraints described in clause 7i7 may be used 7if not contraindicated7 only in emergency situations in which a child presents an imminent danger of harm to self or others and only after less restrictive interventions have been determined to be ineffective4 7,e7 ,access to communications ,each child at such a program-- 7i7 shall have reasonable access to a telephone and means for electronic and written communications1 and be informed of the child's right to such access1 to maintain frequent contact with parents or guardians1 including making1 sending1 and receiving scheduled and unscheduled calls1 unrestricted written correspondence1 and electronic communications1 with as much privacy as possible2 and 7ii7 shall have access to current and appropriate national1 ,state1 and local hotline numbers for reporting child abuse and neglect4 7,f7 ,staff-to-,child ratio ,the program shall have appropriate ratios of medical1 clinical1 and line staff members to children1 as determined by the ,secretary1 to ensure child safety and the efficacy of treatment4 7,g7 ,senior management ,not less than one full-time licensed clinician or mental health practitioner shall be employed as a senior manager of the program4 7,h7 ,licensed clinician ,not less than one licensed clinician shall be present at all times for the program4 ,the licensed clinician may be on call unless having such a clinician physically present is necessary to ensure safety and clinically appropriate care4 7,i7 ,program ,policies ,the program shall have policies to require-- 7i7 parents or guardians of a child attending such a program to notify1 in writing1 such program of any medication the child is taking2 7ii7 a full-time licensed clinician-- 7,i7 to obtain consent from the parents or guardians of the child to make any change to the child's medical treatment1 except in the case of an emergency2 7,,ii7 in the case of an emergency1 to notify the parents or guardians within #bd hours after any change to the child's medical treatment1 to describe the change and the reason for such change2 and 7,,iii7 to notify the parents or guardians within #bd hours after any change to the child's prescribed medication or any occurrence of a missed dose of prescribed medication1 to describe the change or occurrence and the reason for such change or occurrence2 and 7iii7 the covered program to notify parents or guardians of a child of any change to the program's treating provider team within #dh hours after the change4 7,j7 ,notification procedures ,the program shall have procedures for notifying immediately1 to the maximum extent practicable1 but not later than #f hours after the occurrence involved1 parents or guardians of a child at such a program and the appropriate protection and advocacy system of any occurrence of an-- 7i7 onsite investigation of a report of child abuse and neglect2 7ii7 violation of a standard described in any of subparagraphs 7,a7 through 7,d72 and 7iii7 violation of a ,state licensing requirement4 7,k7 ,staff member disclosures ,full disclosure1 in writing1 of staff member qualifications and their roles and responsibilities at such a program1 including any medical1 emergency response1 and mental health training received by such staff members1 shall be given to parents or guardians of children at such a program4 7,l7 ,disclosure of right of action ,full disclosure1 in writing1 of the private right of action established under subsection 7b77#c71 shall be given to parents or guardians of children at such a program4 7,m7 ,child abuse and neglect response training ,each staff member at such a program shall be required1 as a condition of employment1 to become trained in the acts and omissions that constitute child abuse and neglect1 ,state law relating to mandated reporters1 and procedures for reporting child abuse and neglect1 in the ,state in which the program is located1 and information on current and appropriate national1 ,state1 and local hotline numbers for reporting child abuse and neglect4 7,n7 ,medical response training ,each staff member at such a program shall be required1 as a condition of employment1 to become trained in recognizing the signs1 symptoms1 and appropriate responses associated with common medical emergencies and mental health crises1 including warning signs of suicide and worsening symptoms of mental illness4 7,o7 ,criminal history check 7i7 ,requirement ,each staff member for such a program shall be required1 as a condition of employment1 to submit to a criminal history check1 including a name-based search of the ,national ,sex ,offender ,registry established pursuant to the ,adam ,walsh ,child ,protection and ,safety ,act of #bjjf 7#db ,u4,s4,c4 #afija et seq471 a search of the ,state criminal registry or repository in the ,state in which the covered program is operating1 and a ,federal ,bureau of ,investigation fingerprint check4 ,an individual shall be ineligible to serve in a position with any contact with children at a covered program if any such criminal history check reveals a conviction for a violent felony that1 by virtue of its nature1 proximity in time1 or other factor1 is likely to directly increase a child's risk of harm in the program as determined by the ,secretary4 7ii7 ,appeals ,the covered program shall provide an independent process through which a staff member who is determined to be ineligible for employment as a result of a criminal history check under clause 7i7 shall have the right-- 7,i7 to obtain a copy of the report resulting from the check2 and 7,,ii7 within #aj business days after receipt of the report1 to appeal1 in order to dispute the accuracy of the information obtained through the check4 7,p7 ,informational materials ,full disclosure1 in writing1 in promotional and informational materials produced by a covered program1 shall be given to parents or guardians of children at such a program1 which shall include disclosure of-- 7i7 the name and location of the program1 including the names of any owners and operators2 7ii7 the number and percentage of children who terminated participation prior to completion of that program in the past #e years1 including children discharged against medical advice2 7iii7 any past violations of the standards required under this paragraph by the program and any penalties levied against the program as a result of such violations2 7iv7 its current status 7current as of the date the materials were given to the parents or guardians7 with respect to ,state licensing requirements2 7v7 the number of deaths that occurred in that program during the most recent #aj-year period and the cause of each death2 7vi7 the names of owners and operators of the program that have violated ,state licensing requirements2 7vii7 information on evidence-based or promising practices employed as treatment in the covered program1 and information to aid parents and guardians in finding community-based treatment resources2 and 7viii7 any national1 ,state1 and local telephone hotline numbers that the program made available to children and staff members to report complaints of child abuse and neglect1 or a violation of this paragraph1 by the program4 7,q7 ,treatment and discharge plans ,the entity carrying out the covered program shall work with the parents or guardians of a child of the program and the child's community-based providers in the development1 modification1 and implementation of treatment and discharge plans1 including a plan for community reintegration and linkage to community-based providers and supports4 7,r7 ,prohibition on discrimination ,the entity carrying out the program shall ensure that no person shall1 on the basis of actual or perceived race1 color1 religion1 national origin1 sex1 gender identity1 sexual orientation1 or disability1 be subjected to discrimination in the provision of any program or activity1 in whole or in part1 covered by this ,act4 7,s7 ,evidence-based practices ,the entity carrying out the program shall ensure that the program employs safe1 evidence-based practices1 and that children are protected against harmful or fraudulent practices1 including use of isolation or of mechanical restraints or physical restraints4 7,t7 ,other standards ,the program shall meet any other standard the ,secretary determines appropriate to provide for the basic health and safety of children at a covered program4 7#b7 ,regulations 7,a7 ,interim regulations ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall promulgate and enforce interim regulations to carry out paragraph 7#a74 7,b7 ,public comment ,the ,secretary shall1 for a #ij-;day period beginning on the date of the promulgation of interim regulations under subparagraph 7,a71 solicit and accept public comment concerning such regulations4 ,such public comment shall be submitted in written form4 7,c7 ,final regulations ,not later than #ij days after the conclusion of the #ij-;day period referred to in subparagraph 7,b71 the ,secretary shall promulgate and enforce final regulations to carry out paragraph 7#a74 7b7 ,monitoring and enforcement 7#a7 ,review process ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall implement a review process for overseeing1 investigating1 and evaluating reports1 of child abuse and neglect at covered programs1 that are received by the ,secretary from the appropriate ,state1 in accordance with paragraph 7#d7 or 7#e7 of section #aad7;b7 of the ,child ,abuse ,prevention and ,treatment ,act1 as added by section #g of this ,act4 ,such review process shall-- 7,a7 include an investigation to determine if a violation of the standards required under subsection 7a77#a7 has occurred2 and 7,b7 include consultation and collaboration with relevant ,federal and ,state agencies4 7#b7 ,civil penalties ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall promulgate regulations establishing civil penalties for violations of the standards required under subsection 7a77#a74 ,the regulations establishing such penalties shall incorporate the following3 7,a7 ,amount ,any owner or operator of a covered program at which the ,secretary has found a violation of the standards required under subsection 7a77#a7 may be assessed a civil penalty not to exceed #ej1jjj per violation4 7,b7 ,deposit to ,treasury ,all penalties collected under this paragraph shall be deposited in the appropriate account of the ,treasury of the ,united ,states4 7#c7 ,private right of action ,any person who suffers injury by reason of a violation of subsection 7a77#a7 may bring a civil action against the alleged violator to obtain appropriate compensatory damages and injunctive relief or other equitable relief4 7c7 ,action ,the ,secretary shall establish a process to assist ,states in the oversight and enforcement of this ,act1 which shall include-- 7#a7 assisting ,states in implementing oversight mechanisms to ensure compliance of covered programs in the ,states with the standards required under subsection 7a77#a72 7#b7 maintaining oversight of covered programs in a ,state1 in a case in which a ,state has not established1 within #c years after the date of the enactment of this ,act1 mechanisms sufficient to ensure compliance of such programs with the standards required under subsection 7a77#a72 and 7#c7 encouraging the use by ,states of national1 ,state1 or local hotline numbers for reporting child abuse and neglect and any other resources the ,secretary determines to be appropriate4 #d4 ,enforcement by the ,attorney ,general ,if the ,secretary determines that a violation of section #c7;a77#a7 has not been remedied through the enforcement process described in section #c7;b77#b71 the ,secretary shall refer such violation to the ,attorney ,general for appropriate action4 ,regardless of whether such a referral has been made1 the ,attorney ,general may1 sua sponte1 bring an action in any court of competent jurisdiction seeking equitable relief or any other relief authorized by this ,act for such violation4 #e4 ,report ,not later than #a year after the date of enactment of this ,act and annually thereafter1 the ,secretary of ,health and ,human ,services1 in coordination with the ,attorney ,general shall submit to the ,committee on ,education and the ,workforce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 a report on the activities carried out by the ,secretary and the ,attorney ,general1 as authorized and as required under this ,act4 #f4 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary of ,health and ,human ,services #e1jjj1jjj for each of fiscal years #bjag through #bjba to carry out this ,act 7excluding the amendment made by section #g of this ,act74 #g4 ,additional eligibility requirements for grants to ,states to prevent child abuse and neglect at residential programs 7a7 ,in general ,title ,i of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja et seq47 is amended by adding at the end the following new section3 #aad4 ,additional eligibility requirements for grants to ,states to prevent child abuse and neglect at residential programs 7a7 ,definitions ,in this section3 7#a7 ,child ,the term child means an individual who has not attained the age of #ah4 7#b7 ,covered program ,the term covered program has the meaning given the term in section #b of the ,stop ,child ,abuse in ,residential ,programs for ,teens ,act of #bjaf4 7b7 ,eligibility requirements ,to be eligible to receive a grant under section #ajf1 a ,state shall-- 7#a7 not later than #c years after the date of enactment of this section1 develop policies and procedures to prevent child abuse and neglect at covered programs operating in such ,state1 including standards that meet or exceed the standards required under section #c7;a77#a7 of the ,stop ,child ,abuse in ,residential ,programs for ,teens ,act of #bjaf2 7#b7 provide a private right of action under ,state law for any person who suffers injury by reason of a violation of the standards required under paragraph 7#a72 7#c7 develop policies and procedures to enforce compliance with the requirements developed in accordance with paragraph 7#a71 including-- 7,a7 establishing and monitoring health and safety licensing requirements applicable to and necessary for the operation of each location of such covered programs in the ,state2 and 7,b7 conducting unannounced site inspections at each location of a covered program2 7#d7 develop policies and procedures for timely notification to the ,secretary and the appropriate protection and advocacy system if-- 7,a7 the ,state determines there is evidence of a pattern of violations of the standards required under paragraph 7#a7 at a covered program operating in the ,state or by an owner or operator of such a program2 or 7,b7 there is a child fatality at a covered program operating in the ,state2 and 7#e7 annually submit to the ,secretary a report that includes all covered programs within the jurisdiction of the ,state1 including any violations by each program or any information that the ,secretary determines to be necessary for enforcement of this ,act4 7c7 ,oversight ,if1 within the #c-year period beginning on the date of enactment of this section1 the ,secretary determines that the ,state is not satisfying the requirements of this subsection1 the ,secretary shall provide assistance to the ,state to satisfy such requirements or withhold funding until such policies and procedures are established4 4 7b7 ,authorization of ,appropriations ,section #aab7;a77#a7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf;h7a77#a77 is amended by striking #abj1jjj1jjj and all that follows through the period and inserting #bjj1jjj1jjj for each of fiscal years #bjag through #bjba44 7c7 ,conforming amendments 7#a7 ,coordination with available resources ,section #ajc7;c77#a77;,d7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajd7;c77#a77;,d77 is amended by inserting after specific the following3 7including reports of child abuse and neglect occurring at covered programs 7as such term is defined in section #aad71 except that such reports shall not contain any personally identifiable information relating to the identity of individuals who were the victims of such child abuse and neglect74 7#b7 ,further requirement ,section #ajf7;b77#a7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf;a7b77#a77 is amended by adding at the end the following new subparagraph3 7,d7 ,further requirement ,to be eligible to receive a grant under this section1 a ,state shall comply with the requirements under section #aad7;b7 and shall include in the ,state plan submitted pursuant to subparagraph 7,a7 a description of the activities the ,state will carry out to comply with the requirements under such section #aad7;b74 4 7#c7 ,annual state data reports ,section #ajf7;d7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf;a7d77 is amended-- 7,a7 in paragraph 7#a71 by inserting before the period at the end the following3 7including reports of child abuse and neglect occurring at covered programs 7as such term is defined in section #aad71 except that such reports shall not contain any personally identifiable information relating to the identity of individuals who were the victims of such child abuse and neglect72 and 7,b7 in paragraph 7#f71 by inserting before the period at the end the following3 or who were in the care of a covered program1 as such term is defined in section #aad4 7d7 ,clerical amendment ,section #a7;b7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja note7 is amended by inserting after the item relating to section #aac the following new item3 ,sec4 #aad4 ,additional eligibility requirements for grants to ,states to prevent child abuse and neglect at residential programs4 4