,,ii  #aae? ,,congress  #b;d ,session   
,s4 #ceba  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #bg1         
#bjah,mr4 ,casey 7= himself1 ,mr4       
,isakson1 & ,mr4 ,br[n7 introduc$ !     
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,heal?1 ,education1  
,labor1 & ,p5sions  ,a ,,bill  ,to am5d 
! ,public ,heal? ,s]vice ,act to improve
 ! heal? ( *ildr5 & help bett] und]/& & 
enhance aw>5ess ab\t unexpect$ sudd5    
dea? 9 e>ly life4  #a4 ,%ort title ,?is 
,act may be cit$ z ! ,sc>lett's ,sun%9e 
on ,sudd5 ,unexpect$ ,dea? ,act4  #b4   
,am5dm5t to ! ,public ,heal? ,s]vice    
,act ,title ,,iii ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4 #bda et     
seq47 is am5d$ by add+ at ! end !       
foll[+3  ,w ,sudd5 ,unexpect$ ,infant   
,dea? & ,sudd5 ,unexpla9$ ,dea? 9       
,*ildhood  #cii,,oo4 ,def9itions ,9 ?is 
"p3 7#a7 ,adm9i/rator ,! t]m            
,adm9i/rator means ! ,adm9i/rator ( !   
,heal? ,res\rces & ,s]vices             
,adm9i/ration4  7#b7 ,dea? sc5e         

inve/igator ,! t]m dea? sc5e inve/igator
 means an individual c]tifi$ or tra9$ z 
a dea? sc5e inve/igator by an accr$it$  
pr(essional c]tification bo>d4  7#c7    
,director ,! t]m ,director means !      
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion4  7#d7 ,/ate ,! t]m ,/ate 
has ! mean+ giv5 to su* t]m 9 section   
#b1 except t su* t]m includes ,indian   
tribes & tribal organizations 7z su*    
t]ms are def9$ 9 section #d ( ! ,indian 
,self-,det]m9ation & ,education         
,assi/ance ,act74  7#e7 ,sudd5 unexpect$
 infant dea?2 ,,suid ,! t]ms sudd5      
unexpect$ infant dea? & ,,suid mean !   
sudd5 dea? ( an infant "u #a ye> ( age t
 :5 fir/ discov]$ did n h an obvi\s     
cause4 ,su* t]ms include ^? dea?s t are 
lat] det]m9$ to be f expla9$ z well z   
unexpla9$ causes4  7#f7 ,sudd5 unexpla9$
 dea? 9 *ildhood2 ,,sudc ,! t]ms sudd5  
unexpla9$ dea? 9 *ildhood & ,,sudc mean 
! sudd5 dea? ( a *ild :o is #a ye> ( age
 or old]1 :i* rema9s unexpla9$ aft] a   
?or\gh case inve/igation t includes a   

review ( ! cl9ical hi/ory & circum/ances
 ( dea? & p]=mance ( a complete autopsy 
) appropriate ancill>y te/+4            
#cii,,oo-#a4 ,dea? sc5e inve/igation &  
autopsy  7a7 ,inve/igations  7#a7       
,report+ ,! ,secret>y1 act+ ?r\gh !     
,director1 9 consultation ) bo>d-c]tifi$
 =5sic pa?ologi/s1 m$ical exam9]s1      
coron]s1 p$iatric pa?ologi/s1 p$iatric  
c>diologi/s1 p$iatric neuropa?ologi/s & 
g5etici/s1 & o!r individuals & gr\ps z !
 ,director det]m9es necess>y1 %all      
revise ! ,sudd5 ,unexpla9$ ,infant ,dea?
 ,inve/igation ,report+ ,=m ( ! ,c5t]s =
 ,disease ,control & ,prev5tion & !     
,*ild ,dea? ,review ,case ,report+      
,sy/em to include doll re-enactm5ts &   
sc5e inve/igation in=mation on dea?s (  
*ildr5 y\ng] ?an #e4  7#b7 ,grants ,!   
,secret>y1 act+ ?r\gh ! ,director1 %all 
aw>d grants to ,/ates to enable su*     
,/ates to improve ! completion (        
compreh5sive dea? sc5e inve/igations1 & 
reviews ( su* inve/igations1 = sudd5    
unexpect$ infant dea? & sudd5 unexpla9$ 

dea? 9 *ildhood4  7#c7 ,application ,to 
be eligible to receive a grant "u       
p>agraph 7#a71 a ,/ate %all submit to ! 
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require4  7#d7 ,use (     
funds  7,a7 ,9 g5]al ,a ,/ate %all use  
am\nts receiv$ "u a grant "u p>agraph   
7#a7 to improve ! completion (          
compreh5sive dea? sc5e inve/igations =  
sudd5 unexpect$ infant dea? & sudd5     
unexpla9$ dea? 9 *ildhood1 includ+ ?r\gh
 ! aw>d+ ( subgrants to local           
jurisdictions to be us$ to implem5t /&>d
 dea? sc5e inve/igation protocols =     
sudd5 unexpect$ infant dea? & sudd5     
unexpla9$ dea? 9 *ildhood & conduct     
compreh5sive1 /&>diz$ autopsies4  7,b7  
,protocols ,a /&>d dea? sc5e protocol   
implem5t$ "u subp>agraph 7,a7 %all      
include ! obta9+ ( in=mation on curr5t &
 pa/ m$ical hi/ory ( ! infant or *ild1 !
 circum/ances surr\nd+ ! dea?1 includ+  
any suspici\s circum/ances1 :e!r !re 7  
any accid5tal or environm5tal factors   

associat$ ) ! dea?1 & 9 ! case ( a      
sleep-relat$ dea?1 ! sleep position &   
sleep environm5t4  7b7 ,autopsies  7#a7 
,9 g5]al ,! ,secret>y1 act+ ?r\gh !     
,director1 %all aw>d grants to ,/ates & 
local gov]nm5tal entities to enable su* 
,/ates & entities to increase ! rate at 
:i* compreh5sive1 /&>diz$ autopsies are 
p]=m$ = sudd5 unexpect$ infant dea? &   
sudd5 unexpla9$ dea? 9 *ildhood4  7#b7  
,in=m$ cons5t ,grants aw>d$ "u ?is      
subsection may be us$ = /udies &        
demon/ration projects to increase ! rate
 ( cons5t among families ( deceas$      
*ildr5 = ! inclusion ( g5etic or tissue 
samples collect$ dur+ autopsy 9         
regi/ries e/abli%$ = ! purposes (       
conduct+ rese>* into ,,suid & ,,sudc4   
7#c7 ,application ,to be eligible to    
receive a grant "u p>agraph 7#a71 an    
eligible entity describ$ 9 su* p>agraph 
%all submit to ! ,secret>y an           
application at su* "t1 9 su* mann]1 &   
conta9+ su* in=mation z ! ,secret>y may 
require4  7#d7 ,compreh5sive autopsy ,= 

purposes ( ?is subsection1 a            
compreh5sive autopsy1 :i* may include   
m9imally invasive te*niques1 %all       
include a full ext]nal & int]nal        
exam9ation1 includ+ microscopic         
exam9ation1 ( all major organs & tissues
 includ+ ! bra91 complete radiographs1  
vitre\s fluid analysis1 photo           
docum5tation1 metabolic te/+1 toxicology
 scre5+1 &1 :5 indicat$1 select$ g5etic 
& microbiology analyses ( ! infant or   
*ild involv$4  7c7 ,/udy on g5etic      
analysis ,! ,director1 9 consultation ) 
m$ical exam9]s1 coron]s1 =5sic          
pa?ologi/s1 g5etici/s1 rese>*]s1 public 
heal? (ficials1 & o!r individuals &     
gr\ps z ! ,director det]m9es necess>y1  
%all commission a /udy to det]m9e !     
b5efits & appropriat5ess ( g5etic       
analysis = infant & e>ly *ildhood dea?s 
t rema9 unexpla9$ aft] a complete dea?  
sc5e inve/igation & compreh5sive1       
/&>diz$ autopsy4 ,su* /udy %all include 
recomm5dations on develop+ a /&>d       
protocol = use 9 det]m9+ :5 to utilize  

g5etic analysis1 & /&>d protocols = !   
collection & /orage ( specim5s suitable 
= g5etic analysis4  7d7 ,au?orization ( 
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#h1jjj1jjj = ea* ( fiscal ye>s #bjah    
?r\gh #bjbb4  #cii,,oo-#b4 ,tra9+  7a7  
,grants ,! ,secret>y1 act+ ?r\gh !      
,director1 %all aw>d grants to eligible 
entities = ! provision ( tra9+ on dea?  
sc5e inve/igation specific = ,,suid &   
,,sudc4  7b7 ,eligible entities ,to be  
eligible to receive a grant "u          
subsection 7a71 an entity %all-- 7#a7   
be--  7,a7 a ,/ate or local gov]nm5t    
entity2 or  7,b7 a nonpr(it private     
entity2  7#b7 submit to ! ,secret>y an  
application at su* "t1 9 su* mann]1 &   
conta9+ su* in=mation z ! ,secret>y may 
require2 &  7#c7 make publi%+ tra9+     
mat]ials develop$ us+ a grant aw>d$ "u  
subsection 7a7 available on an int]net  
website & at no *>ge to att5dees ( tra9+
 "u subsection 7c77#a74  7c7 ,use (     
funds ,an eligible entity %all use      

am\nts receiv$ "u a grant "u ?is section
 to-- 7#a7 provide tra9+ to m$ical      
exam9]s1 coron]s1 dea? sc5e             
inve/igators1 law en=cem5t p]sonnel1    
ju/ices ( ! peace1 em]g5cy m$ical       
te*nicians1 p>am$ics1 or em]g5cy        
dep>tm5t p]sonnel conc]n+ dea? sc5e     
inve/igations = ,,suid & ,,sudc1 includ+
 ! use ( /&>d dea? sc5e inve/igation    
protocols t include in=mation on !      
curr5t & pa/ m$ical hi/ory ( ! infant or
 *ild1 ! circum/ances surr\nd+ ! dea?   
includ+ any suspici\s circum/ances1 !   
sleep position & sleep environm5t ( !   
infant or *ild1 & :e!r !re 7 any        
accid5tal or environm5tal factors       
associat$ ) ! dea?2  7#b7 provide tra9+ 
directly to individuals :o are          
responsible = conduct+ & review+ dea?   
sc5e inve/igations = sudd5 unexpect$    
infant dea? & sudd5 unexpla9$ dea? 9    
*ildhood2  7#c7 provide tra9+ to        
multidiscipl9>y teams1 includ+ teams t h
 a m$ical exam9] or coron]1 dea? sc5e   
inve/igator1 law en=cem5t repres5tative1

 & an em]g5cy m$ical te*nician or       
p>am$ic2  7#d7 9 ! case ( national &    
,/ate-bas$ grantees t are compris$ (    
m$ical exam9]s1 coron]s1 dea? sc5e      
inve/igators1 law en=cem5t p]sonnel1 or 
em]g5cy m$ical te*nicians & p>am$ics1   
integrate tra9+ "u ! grant on dea? sc5e 
inve/igation ( ,,suid & ,,sudc into     
pr(essional accr$itation & tra9+        
programs2 or  7#e7 9 ! case ( ,/ate &   
local gov]nm5t entity grantees1 obta9   
equipm5t1 includ+ sc5e inve/igation     
kits1 to aid 9 ! completion ( /&>d dea? 
sc5e inve/igation4  7d7 ,au?orization ( 
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#b1jjj1jjj = ea* ( fiscal ye>s #bjah    
?r\gh #bjbb4  #cii,,oo-#c4 ,infant &    
*ild dea? review  7a7 ,prev5tion  7#a7  
,core capacity grants ,! ,secret>y1 act+
 ?r\gh ! ,adm9i/rator & 9 consultation )
 ! ,associate ,commission] ( ! ,*ildr5's
 ,bureau ( ! ,adm9i/ration = ,*ildr5 &  
,families1 %all aw>d grants to ,/ates to
 build & /r5g!n ,/ate capacity s z to   

review #ajj p]c5t ( all infant & *ild   
dea?s1 & to develop & implem5t prev5tion
 /rategies1 z appropriate4  7#b7 ,plann+
 grants ,! ,secret>y1 act+ ?r\gh !      
,adm9i/rator1 %all aw>d plann+ grants to
 ,/ates t h no exi/+ infant or *ild dea?
 review program or ,/ates 9 :i* ! only  
infant & *ild dea? review programs are  
,/ate-bas$1 = ! developm5t ( local      
infant & *ild dea? review programs &    
prev5tion /rategies4  7#c7 ,application 
,to be eligible to receive a grant "u   
p>agraph 7#a7 or 7#b71 a ,/ate %all     
submit to ! ,secret>y an application at 
su* "t1 9 su* mann]1 & conta9+ su*      
in=mation z ! ,secret>y may require4    
7#d7 ,te*nical assi/ance ,! ,secret>y1  
act+ ?r\gh ! ,adm9i/rator1 %all provide 
te*nical assi/ance to assi/ ,/ates--    
7,a7 9 develop+ ! capacity =            
compreh5sive infant & *ild dea? review  
programs1 includ+ ! developm5t ( be/    
practices = ! implem5tation ( su*       
programs2 &  7,b7 9 ma9ta9+ ! ,national 
,infant & ,*ild ,dea? ,case ,report+    

,sy/em4  7b7 ,au?orization (            
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#ae1jjj1jjj = ea* ( fiscal ye>s #bjah   
?r\gh #bjbb4  #cii,,oo-#d4 ,enhanc+ !   
,national ,infant & ,*ild ,dea? ,case   
,report+ ,sy/em  7a7 ,9 g5]al ,!        
,secret>y1 act+ ?r\gh ! ,director & 9   
consultation ) ! ,national ,infant &    
,*ild ,dea? ,case ,report+ ,sy/em1      
national heal? organizations1 &         
pr(essional societies ) exp]i5ce &      
exp]tise relat+ to r$uc+ ,,suid &       
,,sudc1 %all ma9ta9 curr5t ef=ts ( !    
,national ,infant & ,*ild ,dea? ,case   
,report+ ,sy/em s z to provide          
population-bas$ data on dea?s occurr+ = 
*ildr5 "u age #e1 9 ord] to facilitate !
 und]/&+ ( ! root causes1 rates1 tr5ds1 
& geographic v>iations ( ,,suid & ,,sudc
 ) respect to su* age gr\p4  7b7        
,compilation & availability ( data ,!   
,secret>y %all compile ! data submitt$  
"u ?is section & make su* data available
 to ! public 9 a timely mann] on an     

appropriate int]net website 9 a =mat t  
is useful to ! public & to o!r entities4
  7c7 ,au?orization ( appropriations ,to
 c>ry out ?is section1 !re is au?oriz$  
to be appropriat$ #a1jjj1jjj = ea* (    
fiscal ye>s #bjah ?r\gh #bjbb4          
#cii,,oo-#e4 ,grants to support infant  
safe sleep  7a7 ,9 g5]al ,! ,secret>y1  
act+ ?r\gh ! ,adm9i/rator1 %all aw>d    
grants to national organizations1       
community-bas$ organizations1 municipal 
public safety dep>tm5ts1 & nonpr(it     
organizations = ! provision (           
evid5ce-bas$ approa*es = educational    
programs1 & outrea* activities focus$ on
 decreas+ ! risk factors t contribute to
 ,,suid4  7b7 ,application ,to be       
eligible to receive a grant "u          
subsection 7a71 an entity %all submit to
 ! ,secret>y an application at su* "t1 9
 su* mann]1 & conta9+ su* in=mation z ! 
,secret>y may require4  7c7 ,use ( funds
 ,am\nts receiv$ "u a grant aw>d$ "u    
subsection 7a7 may be us$ to-- 7#a7     
provide outrea* & education s]vices     

directly to p>5ts & families1 :i*--     
7,a7 may include home visits1 #bd-;h\r  
hotl9es1 int]net-bas$ educational       
mat]ials1 mobile heal? te*nologies1 &   
social m>ket+ campaigns2  7,b7 %all     
apply curr5t safe sleep guidel9es       
publi%$ by a pr(essional p$iatric       
organization2 &  7,c7 may provide safe  
sleep-relat$ products to families at no 
co/ or at r$uc$ co/ t h publi%$1        
pe]-review$ evid5ce to support saf]     
sleep environm5ts = infants ?r\gh age   
"o2 or  7#b7 build capacity 9           
pr(essionals work+ ) families to support
 safe sleep4  7d7 ,safe-,sleep products 
,any product relat$ to safe sleep = an  
infant t is provid$ "u subsection       
7c77#a77;,c7 %all--  7#a7 be a full-siz$
 crib1 a non-full-siz$ crib1 or a play  
y>d2  7#b7 provide a flat surface2  7#c7
 n include a supplem5tal mattress or s(t
 b$d+2 &  7#d7 be cov]$ by1 & be 9      
compliance )1 a regulation or m&atory   
/&>d promulgat$ by ! ,consum] ,product  
,safety ,commission4  7e7 ,pref]5ce ,9  

aw>d+ grants "u subsection 7a71 !       
,secret>y %all give pref]5ce to         
applicants t h a prov5 hi/ory ( develop+
 or deliv]+ int]v5tions = infants &     
families to support safe sleep1 include 
plans to report evid5ce ( program       
outcomes1 & c demon/rate exp]i5ce ?r\gh 
collaborations & p>tn]%ips = deliv]+    
s]vices ?r\gh\t a ,/ate or region4  7f7 
,set-,aside ,n m ?an #e p]c5t ( ! am\nt 
( funds appropriat$ to c>ry out ?is     
section may be us$ to conduct rese>*    
into ! behavioral risks t lead to unsafe
 sleep practices & ways to mitigate ^?  
risks4  7g7 ,au?orization (             
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#e1jjj1jjj = fiscal ye> #bjah &         
#g1jjj1jjj = ea* ( fiscal ye>s #bjai    
?r\gh #bjbb4  4  #c4 ,s5se ( ,congress  
,x is ! s5se ( ,congress t additional   
rese>* is ne$$ to improve ! und]/&+ ( ! 
epidemiology ( sudd5 unexpla9$ dea? 9   
*ildhood4  #d4 ,report to ,congress ,n  
lat] ?an #a ye> aft] ! date ( enactm5t (

 ?is ,act1 & annually !reaft]1 !        
,secret>y ( ,heal? & ,human ,s]vices1   
act+ ?r\gh ! ,director ( ! ,c5t]s =     
,disease ,control & ,prev5tion & 9      
consultation ) ! ,director ( ! ,national
 ,in/itutes ( ,heal? & ! ,adm9i/rator ( 
! ,heal? ,res\rces & ,s]vices           
,adm9i/ration1 %all submit to !         
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions ( ! ,s5ate & !       
,committee on ,en]gy & ,comm]ce ( !     
,h\se ( ,repres5tatives a report t      
conta9s1 ) respect to ! prec$+ #a-ye>   
report+ p]iod--  7#a7 in=mation reg>d+ !
 absolute numb] & incid5ce ( bo? sudd5  
unexpect$ infant dea? & sudd5 unexpla9$ 
dea? 9 *ildhood1 in=mation ab\t su*     
conditions by racial & e?nic gr\ps1     
in=mation ab\t su* conditions by ,/ate1 
aggregate in=mation obta9$ f dea? sc5e  
inve/igations & autopsies1 &            
recomm5dations = r$uc+ ! incid5ce (     
sudd5 unexpect$ infant dea? & sudd5     
unexpla9$ dea? 9 *ildhood2  7#b7 an     
assessm5t ( ! ext5t to :i* v>i\s        

approa*es ( prev5t+ sudd5 unexpect$     
infant dea? h be5 effective2  7#c7 a    
description ( ! activities c>ri$ out "u 
"p ,w ( title ,,iii ( ! ,public ,heal?  
,s]vice ,act 7z add$ by section #b72 &  
7#d7 any recomm5dations ( ! ,secret>y   
reg>d+ su* "p ,w4