,,ii #aaeth ,,congress #b;d ,session ,s4 #bfif ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #ah1 #bjah ,mr4 ,casey introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to provide grants to ,states to improve and coordinate their response to ensure the safety1 permanency1 and well-being of children at high risk for abuse and neglect4 #a4 ,short title ,this ,act may be cited as the ,supporting ,infant ,plans of ,safe ,care ,implementation ,act4 #b4 ,plans of safe care 7a7 ,in general ,title ,i of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja et seq47 is amended by inserting after section #ajg the following3 #ajg;,a4 ,grants to ,states to improve and coordinate their response to ensure the safety1 permanency1 and well-being of infants affected by substance use 7a7 ,program authorized ,the ,secretary shall make grants to ,states for the purpose of assisting child welfare agencies1 social services agencies1 substance use disorder treatment agencies1 public health agencies1 and maternal and child health agencies to facilitate collaboration in developing1 updating1 and implementing plans of safe care described in section #ajf7;b77#b77;,b77iii74 7b7 ,distribution of funds 7#a7 ,reservations ,of the amounts appropriated under subsection 7h71 the ,secretary shall reserve-- 7,a7 no more than #c percent for the purposes described in subsection 7g72 and 7,b7 up to #b percent for grants to ,indian ,tribes and tribal organizations for purposes consistent with this section1 as the ,secretary determines appropriate4 7#b7 ,allotments to ,states and territories ,the ,secretary shall allot the amount appropriated under subsection 7h7 that remains after application of paragraph 7#a7 on a competitive basis to ,states that apply for such a grant4 7c7 ,application ,a ,state desiring a grant under this section shall submit an application to the ,secretary at such time and in such manner as the ,secretary may require4 ,such application shall include-- 7#a7 a description of-- 7,a7 the impact of substance use disorder in such ,state1 including with respect to the substance or class of substances with the highest incidence of abuse in the previous year in such ,state1 including-- 7i7 the prevalence of substance use disorder in such ,state2 7ii7 the aggregate rate of births in the ,state of infants with prenatal substance exposure 7as determined by hospitals1 insurance claims1 claims submitted to the ,state ,medicaid program1 or other records71 if available2 and 7iii7 the number of infants identified1 for whom a plan of safe care was developed1 and for whom a referral was made for appropriate services1 as reported under section #ajf7;d77#ah72 7,b7 the challenges the ,state faces in developing and implementing plans of safe care in accordance with section #ajf7;b77#b77;,b77iii72 7,c7 the ,state's lead agency for the grant program and how that agency will coordinate with relevant ,state entities and programs1 including the child welfare agency1 the substance use disorder treatment agency1 and the public health agency1 programs funded by the ,residential ,treatment for ,pregnant and ,postpartum ,women grant program of the ,substance ,abuse and ,mental ,health ,services ,administration1 the ,state ,medicaid program1 the maternal1 infant1 and early childhood home visiting program under section #eaa of the ,social ,security ,act1 the ,state judicial system1 and other agencies1 as determined by the ,secretary2 7,d7 how the ,state will monitor local implementation of plans of safe care1 in accordance with section #ajf7;b77#b77;,b77iii77,,ii72 7,e7 how the ,state meets the requirements of section #aibg of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#bg72 7,f7 how the ,state plans to utilize funding authorized under part ,e1 of title ,,iv of the ,social ,security ,act 7#db ,u4,s4,c4 #fgj et seq47 to assist in carrying out any plan of safe care1 including such funding authorized under section #dga7;e7 of such ,act 7as in effect on ,october #a1 #bjah7 for mental health and substance abuse prevention and treatment services and in-home parent skill-based programs and funding authorized under such section #dgb7;j7 7as in effect on ,october #a1 #bjah7 for children with a parent in a licensed residential family-based treatment facility for substance abuse2 and 7,g7 an assessment of the treatment and other services and programs available in the ,state1 to effectively carry out any plan of safe care developed1 including identification of needed treatment1 other services and programs to ensure the well-being of young children and their families affected by substance use disorder2 7#b7 a description of how the ,state plans to use funds for activities described in subsection 7d7 for the purposes of ensuring ,state compliance with requirements under clauses 7ii7 and 7iii7 of section #ajf7;b77#b77;,b72 and 7#c7 an assurance that the ,state will-- 7,a7 comply with this ,act and parts ,b and ,e of title ,,iv of the ,social ,security ,act 7#db ,u4,s4,c4 #fba et seq42 #fgj et seq472 and 7,b7 comply with requirements to refer a child identified as substance-exposed to early intervention services as required pursuant to a grant under part ,c of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adca et seq474 7d7 ,uses of funds ,funds awarded to a ,state under this section may be used for the following activities1 which may be carried out by the ,state directly1 or through grants or subgrants1 contracts1 or cooperative agreements3 7#a7 ,improving ,state and local systems with respect to the development and implementation of plans of safe care1 which-- 7,a7 shall include parent and caregiver engagement1 as required under section #ajf7;b77#b77;,b77iii77,i71 regarding available treatment and service options1 which may include resources available for pregnant1 perinatal1 and postnatal women2 and 7,b7 may include activities such as-- 7i7 developing policies1 procedures1 or protocols for the administration of evidence-based and validated screening tools for infants who may be affected by substance use withdrawal symptoms or a fetal alcohol spectrum disorder and pregnant1 perinatal1 and postnatal women whose infants may be affected by substance use withdrawal symptoms or a fetal alcohol spectrum disorder2 7ii7 improving assessments used to determine the needs of the infant and family2 7iii7 improving ongoing case management services2 and 7iv7 improving access to treatment services1 which may be prior to the pregnant woman's due date4 7#b7 ,developing policies1 procedures1 or protocols in consultation and coordination with health professionals1 public and private health facilities1 and substance use disorder treatment agencies to ensure that-- 7,a7 appropriate notification to child protective services is made in a timely manner2 7,b7 a plan of safe care is in place1 where needed1 before the infant is discharged from the birth or health care facility2 and 7,c7 such health and related agency professionals are trained on how to follow such protocols and are aware of the supports that may be provided under a plan of safe care4 7#c7 ,training health professionals and health system leaders1 child welfare workers1 substance use disorder treatment agencies1 and other related professionals such as home visiting agency staff and law enforcement in relevant topics including-- 7,a7 ,state mandatory reporting laws and the referral and notification process2 7,b7 the co-occurrence of pregnancy and substance use disorder2 7,c7 the clinical guidance about treating substance use disorder in pregnant and postpartum women2 and 7,d7 appropriate screening and interventions for infants affected by substance use disorder1 withdrawal symptoms1 or a fetal alcohol spectrum disorder and the requirements under section #ajf7;b77#b77;,b77iii74 7#d7 ,establishing partnerships1 agreements1 or memoranda of understanding between the lead agency and health professionals1 health facilities1 child welfare professionals1 substance use disorder and mental health disorder treatment programs1 and maternal and child health and early intervention professionals1 including home visiting providers1 peer recovery specialists1 and housing agencies to facilitate the implementation of1 and compliance with section #ajf7;b77#b7 and paragraph 7#b7 of this subsection1 in areas which may include-- 7,a7 developing a comprehensive1 multi-disciplinary assessment and intervention process for infants and their families who are affected by substance use disorder1 withdrawal symptoms1 or a fetal alcohol spectrum disorder1 that takes into account the unique needs of each family and addresses differences between legal1 medically supervised substance use1 and substance use disorder2 7,b7 ensuring that treatment approaches for serving infants1 pregnant women1 and perinatal and postnatal women whose infants may be affected by substance use1 withdrawal symptoms1 or a fetal alcohol spectrum disorder1 are designed to1 where appropriate1 keep infants with their mothers during both inpatient and outpatient treatment2 and 7,c7 increasing access to appropriate evidence-based medication assisted treatment services for substance use disorders approved by the ,food and ,drug ,administration and behavioral therapy1 as appropriate1 and counseling services4 7#e7 ,developing and updating systems of technology for improved data collection and monitoring under section #ajf7;b77#b77;,b77iii71 including existing electronic medical records1 to measure the outcomes achieved through the plans of safe care1 including monitoring systems to meet the requirements of this ,act and submission of performance measures4 7e7 ,reporting ,each ,state that receives funds under this section1 for each year such funds are received1 shall submit a report to the ,secretary1 disaggregated by geographic location1 economic status1 and major racial and ethnic groups as determined by the ,state1 on the following3 7#a7 ,the number of the infants identified under section #ajf7;b77#b77;,b77ii7 who experienced removal due to parental substance use concerns who are reunified with parents1 and the length of time between such removal and reunification4 7#b7 ,the number of the infants identified under section #ajf7;b77#b77;,b77ii7 who experienced substantiated reports of child abuse or neglect1 received differential response while in the care of their birth parents or within #a year after a reunification has occurred4 7#c7 ,the number of the infants identified under section #ajf7;b77#b77;,b77ii7 who experienced a return to out-of-home care within one year after reunification4 7f7 ,secretary's report to congress ,the ,secretary shall submit an annual report to the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,appropriations of the ,senate and the ,committee on ,education and the ,workforce and the ,committee on ,appropriations of the ,house of ,representatives that includes the information described in subsection 7e7 and recommendations or observations on the challenges1 successes1 and lessons derived from implementation of the grant program4 7g7 ,reservation of funds ,the ,secretary shall use the amount reserved under subsection 7b77#a77;,a7 for the purposes of-- 7#a7 providing technical assistance1 including programs of in-depth technical assistance1 to additional ,states1 territories1 and ,indian tribes in accordance with the substance-exposed infant initiative developed by the ,national ,center on ,substance ,abuse and ,child ,welfare2 7#b7 issuing guidance on the requirements of this ,act with respect to infants born with and identified as being affected by substance abuse or withdrawal symptoms or fetal alcohol spectrum disorder1 as described in clauses 7ii7 and 7iii7 of section #ajf7;b77#b77;,b71 including by-- 7,a7 clarifying key terms2 and 7,b7 disseminating best practices on implementation of plans of safe care1 on such topics as differential response1 collaboration and coordination1 and identification and delivery of services1 for different populations2 7#c7 supporting ,state efforts to develop information technology systems to manage plans of safe care2 and 7#d7 preparing the ,secretary's report to ,congress described in subsection 7f74 7h7 ,authorization of appropriations ,to carry out the program under this section1 there are authorized to be appropriated #fj1jjj1jjj for each of fiscal years #bjah through #bjbd4 4 7b7 ,definition ,section #c of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja note7 is amended-- 7#a7 in paragraph 7#g71 by striking 2 and and inserting a semicolon2 7#b7 by redesignating paragraph 7#h7 as paragraph 7#i72 and 7#c7 by inserting after paragraph 7#g7 the following3 7#h7 the term substance use disorder means the abuse of alcohol or other drugs2 and 4