,,ii #aaeth ,,congress #ast ,session ,s4 #ggd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #bi1 #bjag ,ms4 ,heitkamp 7for herself1 ,mr4 ,durbin1 ,mr4 ,franken1 and ,mr4 ,booker7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to address the psychological1 developmental1 social1 and emotional needs of children1 youth1 and families who have experienced trauma1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 #b4 ,findings ,congress makes the following findings3 7#a7 ,the #bjjg ,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 #a or more traumatic events1 such as child maltreatment1 domestic violence1 or sexual assault4 7#b7 ,according to a #bjji ,office of ,juvenile ,justice and ,delinquency ,prevention study of children ages #j through #ag1 more than #fj percent of the children surveyed were exposed to violence within the past year1 either directly or indirectly4 7#c7 ,according to the ,administration for ,children and ,families1 the rate of substantiated reports of child maltreatment in fiscal year #bjae was #i4b per #a1jjj children ages #j through #ag1 with children under age #a having the highest rate of #bd4b per #a1jjj children4 7#d7 ,according to the ,office of ,juvenile ,justice and ,delinquency ,prevention1 a longitudinal study of youth detained at a juvenile detention center in ,chicago showed that #ib4e percent of youth had experienced at least #a trauma1 and #hd percent had experienced more than #a trauma4 7#e7 ,the ,national ,intimate ,partner and ,sexual ,violence ,survey conducted by the ,centers for ,disease ,control and ,prevention revealed that nearly #a in #e women reported having been the victim of a rape at some time during their lives4 ,seventy-eight percent experienced their first rape before the age of #be4 7#f7 ,a #bjag study found that abuse and maltreatment suffered as a child was associated with post-traumatic stress disorder and opioid-related misuse as an adult1 and recommended that trauma history and post-traumatic stress disorder symptom severity be addressed as part of opioid addiction treatment4 7#g7 ,findings from the ,adverse ,childhood ,experiences ,study conducted by the ,centers for ,disease ,control and ,prevention have shown that adverse childhood experiences predispose children towards negative trajectories from infancy through adolescence4 ,followup representative studies have shown the long-range impact of early trauma exposure on adult health conditions1 including heart disease1 asthma1 and mental health4 7#h7 ,according to a subsequent study conducted by the ,centers for ,disease ,control and ,prevention1 adults who had been exposed to multiple adverse childhood experiences were significantly more likely to be unemployed1 to be living in poverty1 and not to have graduated high school than adults who had zero adverse childhood experiences4 7#i7 ,according to a #bjjh finding by the ,national ,child ,traumatic ,stress ,network1 educators who work directly with traumatized children and adolescents are particularly vulnerable to secondary traumatic stress1 experiencing burnout1 fatigue1 irritability1 and other symptoms1 and can be supported through early recognition of that stress1 self-care1 and trauma-informed support systems4 7#aj7 ,findings from a #bjab study conducted by the ,centers for ,disease ,control and ,prevention included an estimate that the total lifetime burden of child maltreatment cases that occur each year in the ,united ,states1 including medical1 welfare1 and criminal justice costs1 is #abd1jjj1jjj1jjj4 7#aa7 ,according to the ,centers for ,disease ,control and ,prevention's ,national ,health and ,nutrition ,examination ,survey1 only half of children ages #h through #ae with a mental disorder had received treatment for their disorder within the past year4 ,children with anxiety disorders such as post-traumatic stress disorder were the least likely to be treated1 with only #cb4b percent having received treatment for a mental disorder in the past year4 7#ab7 ,according to a #bjad report of the ,institute of ,medicine and ,national ,research ,council of the ,national ,academies entitled ,new ,directions in ,child ,abuse and ,neglect ,research1 research has shown that child abuse and neglect experiences resulted in higher risk for behavioral health problems 7such as depression and substance use7 throughout life1 but that with informed prevention approaches1 child abuse and neglect can be both preventable and manageable4 7#ac7 ,according to a #bjag finding by the ,national ,child ,traumatic ,stress ,network1 of the children served by the ,network with problems in the clinical range when entering care1 #hc percent showed significant improvements in post-traumatic stress disorder1 behavioral problems1 or traumatic stress symptoms after receiving evidence-based treatments4 7#ad7 ,according to a #bjjh ,washington ,state report on prevention programs that assessed both cost and effectiveness1 evidence-based1 two-generational child trauma treatments such as ,parent-,child ,interaction ,therapy return #c4fd per dollar of cost4 ,i ,development of best practices #aja4 ,task force to develop best practices for trauma-informed identification1 referral1 and support 7a7 ,establishment of task force ,to identify1 evaluate1 recommend1 maintain1 and update best practices 7#a7 ,establishment ,there is established a task force1 to be known as the ,interagency ,task ,force on ,trauma-,informed ,care4 7#b7 ,main duties ,the task force shall-- 7,a7 identify1 evaluate1 recommend1 maintain1 and update1 as described in subsection 7c7 and in accordance with subsection 7d71 a set of best practices with respect to children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 and 7,b7 carry out other duties as described in subsection 7c74 7b7 ,task force composition 7#a7 ,composition ,the task force shall be composed of ,federal employees1 consisting of the ,assistant ,secretary for ,mental ,health and ,substance ,use 7referred to in this section as the ,assistant ,secretary1 except where another ,assistant ,secretary is specifically named7 and #a representative of each of-- 7,a7 the ,national ,center for ,injury ,prevention and ,control of the ,centers for ,disease ,control and ,prevention2 7,b7 the ,center for ,mental ,health ,services of the ,substance ,abuse and ,mental ,health ,services ,administration2 7,c7 the ,center for ,substance ,abuse ,prevention of that ,administration2 7,d7 the ,center for ,substance ,abuse ,treatment of that ,administration2 7,e7 the ,center for ,behavioral ,health ,statistics and ,quality of that ,administration2 7,f7 the ,maternal and ,child ,health ,bureau of the ,health ,resources and ,services ,administration2 7,g7 the ,center for ,medicaid and ,,chip ,services2 7,h7 the ,national ,institute of ,mental ,health2 7,i7 the ,eunice ,kennedy ,shriver ,national ,institute of ,child ,health and ,human ,development2 7,j7 the ,national ,institute on ,drug ,abuse2 7,k7 the ,national ,institute on ,alcohol ,abuse and ,alcoholism2 7,l7 the ,administration on ,children1 ,youth and ,families of the ,administration for ,children and ,families2 7,m7 the ,administration for ,native ,americans of the ,administration for ,children and ,families2 7,n7 the ,office of ,child ,care of the ,administration for ,children and ,families2 7,o7 the ,office of ,head ,start of the ,administration for ,children and ,families2 7,p7 the ,office of ,refugee ,resettlement of the ,administration for ,children and ,families2 7,q7 the ,indian ,health ,service of the ,department of ,health and ,human ,services2 7,r7 the ,office of ,minority ,health of the ,department of ,health and ,human ,services2 7,s7 the ,office of the ,assistant ,secretary for ,planning and ,evaluation2 7,t7 the ,office of ,juvenile ,justice and ,delinquency ,prevention of the ,department of ,justice2 7,u7 the ,office of ,community ,oriented ,policing ,services of the ,department of ,justice2 7,v7 the ,office on ,violence ,against ,women of the ,department of ,justice2 7,w7 the ,national ,center for ,education ,evaluation and ,regional ,assistance of the ,department of ,education2 7,x7 the ,office of ,safe and ,healthy ,students of the ,department of ,education2 7,y7 the ,office of ,special ,education and ,rehabilitative ,services of the ,department of ,education2 7,z7 the ,office of ,indian ,education of the ,department of ,education2 7,,aa7 the ,bureau of ,indian ,affairs of the ,department of the ,interior2 7,,bb7 the ,bureau of ,indian ,education of the ,department of the ,interior2 7,,cc7 the ,veterans ,health ,administration of the ,department of ,veterans ,affairs2 7,,dd7 the ,office of ,special ,needs ,assistance ,programs of the ,department of ,housing and ,urban ,development2 and 7,,ee7 such other ,federal agencies as-- 7i7 the ,assistant ,secretary recommends to the ,president2 and 7ii7 the ,president determines to be appropriate4 7#b7 ,appointment 7,a7 ,in general ,each member of the task force1 other than the ,assistant ,secretary1 shall be appointed by the ,secretary or other head of the entire ,federal agency that contains the office or other unit of government that the member represents4 7,b7 ,date of appointments ,the heads of ,federal agencies with appointing authority under this paragraph shall appoint the corresponding members of the task force not later than #f months after the date of enactment of this ,act4 7#c7 ,chairperson ,the task force shall be chaired by the ,assistant ,secretary4 7c7 ,task force duties ,the task force shall-- 7#a7 not later than #a year after the date of enactment of this ,act1 and not less often than annually thereafter-- 7,a7 identify and evaluate a set of evidence-based1 evidence-informed1 and promising best practices1 which may include practices already supported by offices of the ,department of ,health and ,human ,services1 including the ,national ,mental ,health and ,substance ,use ,policy ,laboratory1 the ,department of ,justice1 the ,department of ,education1 or another ,federal agency1 with respect to-- 7i7 the early identification of children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 7ii7 the expeditious referral of such children and youth1 and their families as appropriate1 that require specialized services to the appropriate trauma-informed support 7including treatment7 services1 in accordance with applicable privacy laws2 and 7iii7 the implementation of trauma-informed approaches and interventions in child and youth-serving schools1 organizations1 homes1 and other settings to foster safe1 stable1 and nurturing environments and relationships that prevent and mitigate the effects of trauma2 7,b7 recommend such set of best practices1 including disseminating the set1 to the ,department of ,health and ,human ,services1 the ,department of ,justice1 the ,department of ,education1 other ,federal agencies as appropriate1 ,state1 tribal1 and local government agencies1 including ,state1 local1 and tribal educational agencies1 and other entities 7including recipients of relevant ,federal grants1 professional associations1 health professional organizations1 national and ,state accreditation bodies1 and schools7 that the ,assistant ,secretary determines to be appropriate1 and to the general public2 and 7,c7 maintain and update1 as appropriate1 the set of best practices recommended under subparagraph 7,b72 7#b7 not later than #b years after the date of enactment of this ,act-- 7,a7 prepare an integrated task force strategy report concerning how the task force and member agencies will collaborate1 prioritize options for1 and implement a coordinated approach to preventing trauma1 and identifying and ensuring the appropriate interventions and supports for children1 youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 7,b7 submit the report to the appropriate committees of ,congress2 and 7,c7 make the report publicly available2 and 7#c7 not later than #a year after the date of enactment of this ,act1 and as often as practicable but not less often than annually thereafter1 coordinate1 to the extent feasible1 among the offices and other units of government represented on the task force1 research1 data collection1 and evaluation regarding models described in subsection 7d77#a77;,c71 identify gaps in or populations or settings not served by models described in that subsection1 solicit feedback on the models1 from the stakeholders described in subsection 7d77#a77;,b71 coordinate1 among the offices and other units of government represented on the task force1 the awarding of grants related to preventing and mitigating trauma1 and establish procedures to enable the offices and units of government to share technical expertise related to preventing and mitigating trauma4 7d7 ,best practices 7#a7 ,in general ,in identifying1 evaluating1 recommending1 maintaining1 and updating the set of best practices under subsection 7c71 the task force shall-- 7,a7 consider findings from evidence-based1 evidence-informed1 and promising practice-based models1 including from institutions of higher education1 community practice 7including tribal experience71 recognized professional associations1 and programs of the ,department of ,health and ,human ,services1 the ,department of ,justice1 the ,department of ,education1 and other ,federal agencies 7including the ,national ,mental ,health and ,substance ,use ,policy ,laboratory and offices in such agencies that maintain registries and clearinghouses of relevant models71 that reflect the science of healthy child1 youth1 and family development1 and have been developed1 implemented1 and evaluated to demonstrate effectiveness or positive measurable outcomes2 7,b7 engage with1 and solicit and receive feedback from-- 7i7 faculty at institutions of higher education1 community practitioners associated with the community practice described in subparagraph 7,a71 and recognized professional associations that represent the experience and perspectives of individuals who provide services in covered settings1 to obtain observations and practical recommendations on the best practices2 and 7ii7 the public1 by-- 7,i7 holding at least one public meeting to solicit recommendations and information relating to the best practices2 and 7,,ii7 providing notice of the meeting in the ,federal ,register2 7,c7 recommend models for settings in which individuals may come into contact with children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma1 including schools1 hospitals1 settings where health care providers1 including primary care and pediatric providers1 provide services1 preschool and early childhood education and care settings1 home visiting settings1 after-school program facilities1 child welfare agency facilities1 public health agency facilities1 mental health treatment facilities1 substance abuse treatment facilities1 faith-based institutions1 domestic violence centers1 homeless services system facilities1 refugee services system facilities1 juvenile justice system facilities1 and law enforcement agency facilities2 7,d7 recommend best practices that are evidence-based1 are evidence-informed1 or are promising and practice-based1 and that include guidelines for-- 7i7 7,i7 training of front-line service providers1 including teachers1 providers from child- or youth-serving organizations1 health care providers1 individuals who are mandatory reporters of child abuse or neglect1 and first responders1 in understanding and identifying early signs and risk factors of trauma in children and youth1 and their families as appropriate1 including through screening processes2 and 7,,ii7 implementing appropriate responses2 7ii7 procedures or systems that-- 7,i7 are designed to quickly refer children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma to1 and ensure the children1 youth1 and appropriate family members receive1 the appropriate trauma-informed screening and support1 including treatment2 or 7,,ii7 use partnerships that-- 7aa7 include local social services organizations or clinical mental health or health care service providers with expertise in furnishing support services 7including trauma-informed treatment7 to prevent or mitigate the effects of trauma2 7bb7 may be partnerships that co-locate or integrate services1 such as by providing services at school-based health centers2 and 7cc7 are designed to make such quick referrals1 and ensure the receipt of screening1 support1 and treatment1 described in subclause 7,i72 7iii7 educating children and youth to-- 7,i7 understand trauma2 7,,ii7 identify the signs1 effects1 or symptoms of trauma2 and 7,,iii7 build the resilience and coping skills to mitigate the effects of experiencing trauma2 7iv7 multi-generational interventions to-- 7,i7 support1 including through skills building1 parents 7with an appropriate emphasis on fathers71 foster parents1 adult caregivers1 and front-line service providers described in clause 7i77,i7 in fostering safe1 stable1 and nurturing environments and relationships that prevent and mitigate the effects of trauma for children and youth who have experienced or are at risk of experiencing trauma2 7,,ii7 assist parents1 foster parents1 and adult caregivers in learning to access resources related to such prevention and mitigation2 and 7,,iii7 provide tools to prevent and address caregiver or secondary trauma1 as appropriate2 7v7 community interventions for underserved areas that have faced trauma through acute or long-term exposure to substantial discrimination1 historical or cultural oppression1 intergenerational poverty1 civil unrest1 a high rate of violence1 or a high rate of drug overdose mortality2 7vi7 assisting parents and guardians in understanding eligibility for and obtaining certain health benefits coverage1 including coverage under a ,state ,medicaid plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 of screening and treatment for children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 7vii7 utilizing trained nonclinical providers 7such as peers through peer support models1 mentors1 clergy1 and other community figures71 to-- 7,i7 expeditiously link children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma1 to the appropriate trauma-informed screening and support 7including clinical treatment7 services2 and 7,,ii7 provide ongoing care or case management services2 7viii7 collecting and utilizing data from screenings1 referrals1 or the provision of services and supports1 conducted in the covered settings1 to evaluate and improve processes for trauma-informed support and outcomes2 7ix7 7,i7 improving disciplinary practices in early childhood education and care settings and schools1 including use of positive disciplinary strategies that are effective at reducing the incidence of punitive school disciplinary actions1 including school suspensions and expulsions2 and 7,,ii7 providing the training described in clause 7i7 to child care providers and to school personnel1 including school resource officers1 teacher assistants1 administrators1 and heads of charter schools2 and 7x7 incorporating trauma-informed considerations into educational1 preservice1 and continuing education opportunities1 for the use of health professional and education organizations1 national and ,state accreditation bodies for health care and education providers1 health and education professional schools or accredited graduate schools1 and other relevant training and educational entities2 7,e7 recommend best practices that-- 7i7 include practices that are culturally sensitive1 linguistically appropriate1 age- and gender-relevant1 and appropriate for lesbian1 gay1 bisexual1 transgender1 and queer populations2 7ii7 can be applied across underserved geographic areas2 and 7iii7 engage entire organizations in training and skill building related to the best practices2 and 7,f7 recommend best practices that are designed not to lead to unwarranted custody loss or criminal penalties for parents or guardians in connection with children and youth who have experienced or are at risk of experiencing trauma4 7e7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #c1jjj1jjj for fiscal year #bjah and #a1jjj1jjj for each of fiscal years #bjai through #bjbb4 7f7 ,definitions ,in this section3 7#a7 ,covered recipient ,the term covered recipient means a department or other entity described in subsection 7c77#a77;,b74 7#b7 ,covered setting ,the term covered setting means a setting described in subsection 7d77#a77;,c74 #ajb4 ,donald ,j4 ,cohen ,national ,child ,traumatic ,stress ,initiative ,section #ehb7;f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh-#a7;f77 is amended-- 7#a7 by striking #df1hhg1jjj and inserting #ff1hhg1jjj2 and 7#b7 by adding at the end the following3 ,of the amounts appropriated under this subsection for each of fiscal years #bjah through #bjbb1 #g1ejj1jjj shall be allocated to the operation of the coordinating center of the ,national ,child ,traumatic ,stress ,initiative for purposes of gathering and reporting data1 evaluating models1 and providing technical assistance44 ,,ii ,dissemination and implementation of best practices #bja4 ,use of grant funds for training in best practices relating to child and youth trauma and community support 7a7 ,head ,start ,act 7#a7 ,in general ,section #fdj7;a7 of the ,head ,start ,act 7#db ,u4,s4,c4 #ihce7;a77 is amended-- 7,a7 by redesignating paragraph 7#g7 as paragraph 7#h72 and 7,b7 by inserting after paragraph 7#f7 the following3 7#g7 ,any of the funds allocated under this subsection for ,head ,start programs 7including ,early ,head ,start programs71 for training and technical assistance activities1 or for collaboration grants may be used to provide training for administrators and other staff of ,head ,start agencies in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7#b7 ,conforming amendments 7,a7 ,section #fdj7;a77#b77;,c77i7 of the ,head ,start ,act 7#db ,u4,s4,c4 #ihce7;a77#b77;,c77i771 in the matter preceding subclause 7,i71 by inserting after training and technical assistance activities the following3 7such as training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag74 7,b7 ,sections #fda;,a7h77#a77;,b7 and #fde7;d77#c7 of the ,head ,start ,act 7#db ,u4,s4,c4 #ihcf;a7h77#a77;,b71 #ihdj7;d77#c77 are amended by striking #fdj7;a77#g7 and inserting #fdj7;a77#h74 7,c7 ,section #fdb;,b7a77#b77;,b77i7 of the ,head ,start ,act 7#db ,u4,s4,c4 #ihcg;b7a77#b77;,b77i77 is amended by inserting before the semicolon the following3 7such as by providing training for administrators and other staff of those agencies in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag74 7,d7 ,section #fdh of the ,head ,start ,act 7#db ,u4,s4,c4 #ihdc7 is amended-- 7i7 in subsection 7a77#c77;,b77i71 by inserting after systems the following3 7such as systems that include training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag72 7ii7 in subsection 7b77#b77;,c71 by inserting before the semicolon the following3 7such as training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag72 and 7iii7 in subsection 7d77#a77;,g71 by inserting after staff training the following 7such as training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag74 7b7 ,child ,care and ,development ,block ,grant ,section #feh;,g7b77#a7 of the ,child ,care and ,development ,block ,grant ,act of #aiij 7#db ,u4,s4,c4 #iheh;e7b77#a77 is amended-- 7#a7 in subparagraph 7,g71 by striking 2 and and inserting a semicolon2 7#b7 in subparagraph 7,h71 by striking the period and inserting 2 and2 and 7#c7 by adding at the end the following3 7,i7 providing training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag for administrators of child care programs1 and child care providers1 that receive assistance under this subchapter4 4 7c7 ,social ,services ,block ,grant ,section #bjjb7;a77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;a7a77#b77;,b7 is amended-- 7#a7 in clause 7ii71 by striking and after the semicolon2 7#b7 in clause 7iii71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new clause3 7iv7 training for providers in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7d7 ,maternal and ,child ,health ,services ,block ,grant ,section #ejd of the ,social ,security ,act 7#db ,u4,s4,c4 #gjd7 is amended by adding at the end the following new subsection3 7e7 ,a ,state may use a portion of the amounts described in subsection 7a7 for the purpose of providing training for licensed health care providers and public health agencies in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7e7 ,maternal1 ,infant1 and ,early ,childhood ,home ,visiting 7,,miechv7 ,section #eaa7;i77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #gaa7;i77#b77 is amended-- 7#a7 by redesignating subparagraphs 7,d7 through 7,g7 as subparagraphs 7,e7 through 7,h71 respectively2 and 7#b7 by inserting after subparagraph 7,c7 the following new subparagraph3 7,d7 ,section #ejd7;e7 7relating to the use of funds for training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag74 4 7f7 ,child ,welfare ,services ,section #dbb7;b77#d77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #fbb7;b77#d77;,b77 is amended by inserting before the semicolon 7which may include training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag74 7g7 ,federal payments for foster care and adoption assistance ,section #dgd7;a77#c77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #fgd7;a77#c77;,a77 is amended by inserting 1 and including training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag after enrolled in such institutions4 7h7 ,healthy start initiative ,section #ccj;,h7e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;c-#h7;e77 is amended by adding at the end the following3 7#c7 ,training providers in best practices relating to trauma ,any of the funds appropriated under paragraph 7#a7 may be used to provide training for providers in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7i7 ,block grants for community mental health services ,section #aibj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#i7 is amended by adding at the end the following3 7d7 ,training providers in best practices relating to trauma ,except as specified in subsection 7c71 any of the funds appropriated under subsection 7a7 may be used to provide training for providers in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7j7 ,block grants for prevention and treatment of substance abuse ,section #aice of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#ce7 is amended by adding at the end the following3 7c7 ,allocations for training providers in best practices relating to trauma ,any of the funds appropriated under subsection 7a7 may be used to provide training for providers in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7k7 ,use of grant funds for training providers in best practices relating to trauma 7#a7 ,school-based health centers ,section #cii,z-#a7l7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;h-#e7l77 is amended by adding ,any of the funds appropriated under this subsection may be used to provide training for providers in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 after the first sentence4 7#b7 ,community health centers ,section #ccj7r7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7r77 is amended by adding at the end the following3 7#e7 ,training providers in best practices relating to trauma ,any of the funds appropriated under this subsection may be used to provide training for providers in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7l7 ,supporting effective instruction2 local use of funds ,section #bajc7;b77#c7 of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ffac7;b77#c77 is amended-- 7#a7 in subparagraph 7,o71 by striking and after the semicolon2 7#b7 by redesignating subparagraph 7,p7 as subparagraph 7,q72 and 7#c7 by inserting after subparagraph 7,o7 the following3 7,p7 providing training for school personnel1 including teachers1 principals1 other school leaders1 specialized instructional support personnel1 and paraprofessionals1 in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag2 and 4 7m7 ,student support and academic enrichment 7#a7 ,state use of funds ,section #dajd7;b7 of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gaad7;b77 is amended-- 7,a7 in paragraph 7#b71 by striking or at the end2 7,b7 in paragraph 7#c7 by striking the period at the end and inserting 2 or2 and 7,c7 by adding at the end the following3 7#d7 providing training for teachers1 administrators1 school counselors1 mental health professionals1 and other appropriate personnel in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7#b7 ,local use of funds ,paragraph 7#e7 of section #dajh of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gaah7 is amended-- 7,a7 in subparagraph 7,h71 by striking or at the end2 7,b7 in subparagraph 7,i71 by striking the period at the end and inserting 2 or2 and 7,c7 by adding at the end the following3 7,j7 providing training for teachers1 administrators1 school counselors1 mental health professionals1 and other appropriate personnel in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7n7 #bast century community learning centers 7#a7 ,state use of funds ,section #dbjb7;c77#c7 of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gagb7;c77#c77 is amended-- 7,a7 by redesignating subparagraphs 7,h71 7,i71 and 7,g71 as subparagraphs 7,g71 7,h71 and 7,i71 respectively2 and 7,b7 by adding at the end the following3 7,j7 ,providing training for teachers1 administrators1 school counselors1 mental health professionals1 and other appropriate personnel 7including appropriate personnel involved with programs and activities that advance student academic achievement and support student success during nonschool hours7 in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7#b7 ,local use of funds ,section #dbje7;a7 of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gage7;a77 is amended-- 7,a7 in paragraph 7#ac71 by striking and at the end2 7,b7 in paragraph 7#ad71 by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following3 7#ae7 training for teachers1 administrators1 school counselors1 mental health professionals1 and other appropriate personnel in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7o7 ,full-,service community schools ,section #dfbe7;e7 of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gbge7;e77 is amended-- 7#a7 in paragraph 7#b71 by striking and after the semicolon2 7#b7 by redesignating paragraph 7#c7 as paragraph 7#d72 and 7#c7 by inserting after paragraph 7#b7 the following3 7#c7 provide training for teachers1 administrators1 school counselors1 mental health professionals1 and other appropriate personnel 7including appropriate personnel involved with the full-service community school7 in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag2 and 4 7p7 ,national ,activities for ,schools ,section #dfca7;a77#a77;,b7 of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gbha7;a77#a77;,b77 is amended by striking or conducting a national evaluation4 and inserting 1 conducting a national evaluation1 or providing training for teachers1 administrators1 school counselors1 mental health professionals1 and other appropriate personnel in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag44 7q7 ,,idea ,section #fch of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adch7 is amended-- 7#a7 in paragraph 7#d71 by striking and after the semicolon2 7#b7 in paragraph 7#e71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7#f7 to provide training for appropriate personnel who provide direct early intervention services for infants and toddlers with disabilities in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7r7 ,special supplemental nutrition program for women1 infants1 and children ,section #ag7;f7 of the ,child ,nutrition ,act of #aiff 7#db ,u4,s4,c4 #aghf7;f77 is amended by adding at the end the following3 7#bg7 ,best practices ,a ,state agency may use a portion of the amounts made available to the ,state agency under this section for the purpose of providing training for local agencies in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7s7 ,community services block grant act 7#a7 ,state activities ,section #fge;,c7b77#a77;,a7 of the ,community ,services ,block ,grant ,act 7#db ,u4,s4,c4 #iijg7;b77#a77;,a77 is amended by inserting after providing training the following3 7which may include providing training1 to the entities that are providers of services to children and youth1 in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag74 7#b7 ,national activities ,section #fgh;,a7a77#a77;,a7 of the ,community ,services ,block ,grant ,act 7#db ,u4,s4,c4 #iiac7;a77#a77;,a77 is amended by inserting after training the following3 7which may include providing training1 to the entities that are providers of services to children and youth1 in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag74 7t7 ,runaway and homeless youth act ,section #cdb of the ,runaway and ,homeless ,youth ,act 7#db ,u4,s4,c4 #egad-bb7 is amended by inserting after technical assistance and training the following3 7which may include providing training1 to providers of services under this title1 in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag74 7u7 ,programs of the office of refugee resettlement ,section #dfb7;b77#a7 of the ,homeland ,security ,act of #bjjb 7#f ,u4,s4,c4 #bgi7;b77#a77 is amended-- 7#a7 in subparagraph 7,k71 by striking and at the end2 7#b7 in subparagraph 7,l71 by striking the period and inserting 2 and2 and 7#c7 by adding at the end the following3 7,m7 at the election of the ,director1 providing training1 to providers responsible for the care of the unaccompanied alien children1 in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7v7 ,child abuse prevention and treatment 7#a7 ,national clearinghouse ,section #ajc7;b7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajd7 is amended-- 7,a7 in paragraph 7#h71 by striking and at the end2 7,b7 in paragraph 7#i71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7#aj7 disseminate information regarding the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag for individuals and officials described in paragraph 7#h74 4 7#b7 ,research and assistance activities ,section #ajd7;b77#a7 of that ,act 7#db ,u4,s4,c4 #eaje7;b77#a77 is amended by adding at the end the following3 ,such assistance may include technical assistance regarding the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag44 7#c7 ,training ,section #aje7;a77#a7 of that ,act 7#db ,u4,s4,c4 #eajf7;a77#a77 is amended-- 7,a7 in subparagraph 7,l71 by striking and at the end2 7,b7 in subparagraph 7,m71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7,d7 for providing training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag to individuals and entities described in this paragraph4 4 7#d7 ,state child abuse or neglect prevention and treatment programs ,section #ajf7;a7 of that ,act 7#db ,u4,s4,c4 #eajf;a7a77 is amended-- 7,a7 in paragraph 7#ac71 by striking or at the end2 7,b7 in paragraph 7#ad71 by striking the period and inserting 2 or2 and 7,c7 by adding at the end the following3 7#ae7 providing training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag for employees of agencies or systems described in paragraph 7#ab71 7#ac71 or 7#ad74 4 7#e7 ,community-based grants for the prevention of child abuse and neglect ,section #bje7;b7 of that ,act 7#db ,u4,s4,c4 #eaaf;e7b77 is amended-- 7,a7 in paragraph 7#e71 by striking and at the end2 7,b7 in paragraph 7#f71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7#g7 provide training in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag for providers of programs1 activities1 or services described in this subsection4 4 7w7 ,grants for juvenile and family court personnel ,section #bbb7a7 of the ,victims of ,child ,abuse ,act of #aiij 7#db ,u4,s4,c4 #acjbb7a77 is amended by inserting 7which may include providing training1 to the entities that are providers of services to children and youth1 in the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag7 after technical assistance and training4 7x7 ,grants ,to support families in the justice system ,section #acja7;c7 of the ,victims of ,trafficking and ,violence ,protection ,act of #bjjj 7#db ,u4,s4,c4 #ajdbj7;c77 is amended by adding at the end the following3 7#c7 ,best practices for trauma-informed care for children and families ,in making grants under subsection 7b71 the ,attorney ,general shall take into account the extent to which the applicant is using the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 #bjb4 ,establishment of law enforcement child and youth trauma coordinating center 7a7 ,establishment of ,center 7#a7 ,in general ,the ,attorney ,general shall establish a ,national ,law ,enforcement ,child and ,youth ,trauma ,coordinating ,center 7referred to in this section as the ,center7 to provide assistance to ,state1 local1 and tribal law enforcement agencies in interacting with children and youth who have been exposed to violence or other trauma1 and their families as appropriate4 7#b7 ,age range ,the ,center shall determine the age range of children and youth to be covered by the activities of the ,center4 7b7 ,duties ,the ,center shall provide assistance to ,state1 local1 and tribal law enforcement agencies by-- 7#a7 disseminating information on the best practices for law enforcement officers developed under section #aja1 which may include best practices based on evidence-based and evidence-informed models from programs of the ,department of ,justice and the ,office of ,justice ,services of the ,bureau of ,indian ,affairs1 such as-- 7,a7 models developed in partnership with national law enforcement organizations1 ,indian tribes1 or clinical researchers2 and 7,b7 models that include-- 7i7 trauma-informed approaches to conflict resolution1 de-escalation1 and crisis intervention training2 7ii7 early interventions that link child and youth witnesses and victims1 and their families as appropriate1 to appropriate trauma-informed services2 and 7iii7 supporting officers who experience secondary trauma2 7#b7 providing professional training and technical assistance2 and 7#c7 awarding grants under subsection 7c74 7c7 ,grant program 7#a7 ,in general ,the ,attorney ,general1 acting through the ,center1 may award grants to ,state1 local1 and tribal law enforcement agencies or to multi-disciplinary consortia to-- 7,a7 enhance the awareness of best practices developed under section #aja for trauma-informed responses to children and youth who have been exposed to violence or other trauma1 and their families as appropriate2 and 7,b7 provide professional training and technical assistance in implementing the best practices described in subparagraph 7,a74 7#b7 ,application ,any ,state1 local1 or tribal law enforcement agency seeking a grant under this subsection shall submit an application to the ,attorney ,general at such time1 in such manner1 and containing such information as the ,attorney ,general may require4 7#c7 ,use of funds ,a grant awarded under this subsection may be used to-- 7,a7 provide training to law enforcement officers on the best practices developed under section #aja1 including how to identify early signs of trauma and violence exposure when interacting with children and youth2 and 7,b7 establish1 operate1 and evaluate a referral and partnership program with trauma-informed clinical mental health1 substance use1 health care1 or social service professionals in the community in which the law enforcement agency serves4 7d7 ,authorization of appropriations ,there are authorized to be appropriated to the ,attorney ,general-- 7#a7 #ae1jjj1jjj for each of fiscal years #bjah through #bjbb to award grants under subsection 7c72 and 7#b7 #b1jjj1jjj for each of fiscal years #bjah through #bjbb for other activities of the ,center4 #bjc4 ,establishment of ,native ,american technical assistance resource center 7a7 ,definitions ,in this section3 7#a7 ,indian tribe2 tribal organization ,the terms ,indian tribe and tribal organization have the meanings given the terms in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#b7 ,institution of higher education ,the term institution of higher education has the meaning given the term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja74 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services1 acting-- 7,a7 through the ,assistant ,secretary for ,mental ,health and ,substance ,use2 and 7,b7 after consultation with-- 7i7 the ,director of the ,bureau of ,indian ,education of the ,department of the ,interior2 and 7ii7 the ,director of the ,indian ,health ,service4 7b7 ,establishment of ,center ,the ,secretary shall establish and operate a ,native ,american ,technical ,assistance ,resource ,center 7referred to in this section as the ,center7 to provide assistance to ,indian tribes4 7c7 ,duties ,the ,center shall provide assistance to the ,indian tribes by-- 7#a7 providing trauma-informed technical assistance to tribal organizations in implementing the best practices developed under section #aja2 and 7#b7 disseminating the best practices to the tribal organizations1 to schools that serve students from the ,indian tribes1 to health care entities that serve the ,indian tribes1 to child welfare systems that serve children and youth from the ,indian tribes1 to law enforcement agencies that serve the ,indian tribes1 to criminal justice and court systems that serve the ,indian tribes1 and other relevant entities4 7d7 ,grant program 7#a7 ,in general ,the ,secretary may award grants to nonprofit organizations or institutions of higher education1 to operate the ,center4 7#b7 ,application ,an organization or institution seeking a grant under this subsection shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary1 to carry out this section1 #b1jjj1jjj for each of fiscal years #bjah through #bjba4 #bjd4 ,grants to improve trauma support services and mental health care for children and youth in educational settings ,part ,a of title ,,iv of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gaja et seq47 is amended by adding at the end the following3 #c ,grants ,to improve trauma support services and mental health care for children and youth in educational settings #daca4 ,grants to improve trauma support services and mental health care for children and youth in educational settings 7a7 ,grants1 contracts1 and cooperative agreements authorized ,the ,secretary is authorized to award grants to1 or enter into contracts or cooperative agreements with1 ,state educational agencies1 local educational agencies1 ,indian tribes or their tribal educational agencies1 a school operated by the ,bureau of ,indian ,education1 or a ,regional ,corporation 7as defined in section #c of the ,alaska ,native ,claims ,settlement ,act 7#dc ,u4,s4,c4 #afjb77 for the purpose of increasing student access to quality trauma support services and mental health care by developing innovative programs to link local school systems with local trauma-informed support and mental health systems1 including those under the ,indian ,health ,service4 7b7 ,duration ,with respect to a grant1 contract1 or cooperative agreement awarded or entered into under this section1 the period during which payments under such grant1 contract or agreement are made to the recipient may not exceed #e years4 7c7 ,use of funds ,an entity that receives a grant1 contract1 or cooperative agreement under this section shall use amounts made available through such grant1 contract1 or cooperative agreement for any of the following3 7#a7 ,to enhance1 improve1 or develop collaborative efforts between school-based service systems and trauma-informed support and mental health service systems to provide1 enhance1 or improve prevention1 screening1 referral1 and treatment services to students4 7#b7 ,to enhance the availability of trauma support services and school-based counseling programs1 and provide appropriate referrals and interventions for students potentially in need of mental health services4 7#c7 ,to provide universal trauma screenings to identify students in need of specialized support4 7#d7 ,to implement multi-tiered positive behavioral interventions and supports1 or other trauma-informed models of support4 7#e7 ,to provide training to teachers1 teacher assistants1 specialized instructional support personnel1 and mental health professionals to-- 7,a7 develop safe1 stable1 and nurturing learning environments that prevent and mitigate the effects of trauma1 including through social and emotional learning2 or 7,b7 improve school capacity to identify1 refer1 and provide services1 as appropriate1 to students in need of trauma support or behavioral health services4 7#f7 ,to provide technical assistance and consultation to school systems and mental health agencies as well as to families participating in the program carried out under this section4 7#g7 ,to provide linguistically appropriate and culturally competent services4 7#h7 ,to evaluate the effectiveness of the program carried out under this section in increasing student access to quality trauma support services and mental health care1 and make recommendations to the ,secretary about the sustainability of the program4 7#i7 ,to engage and utilize expertise provided by institutions of higher education1 such as a ,tribal ,college or ,university1 as defined in section #caf7;b7 of the ,higher ,education ,act of #aife4 7#aj7 ,to provide trainings and implement procedures pursuant to the relevant best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 7d7 ,applications ,to be eligible to receive a grant1 contract1 or cooperative agreement under this section1 an entity described in subsection 7a7 shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may reasonably require1 such as the following3 7#a7 ,a description of the program to be funded under the grant1 contract1 or cooperative agreement4 7#b7 ,a description of how such program will increase access to quality trauma support services and mental health care for students4 7#c7 ,a description of how the applicant will establish trauma support services or a school-based counseling program1 or both1 that provide immediate prevention and mental health services to the school community as necessary4 7#d7 ,an assurance that-- 7,a7 persons providing services under the grant1 contract1 or cooperative agreement are adequately trained to provide such services2 7,b7 the services will be provided in accordance with subsection 7c72 7,c7 teachers1 administrators1 specialized instructional support personnel1 parents or guardians1 representatives of local ,indian tribes1 and other school personnel are aware of the program2 and 7,d7 parents or guardians of students participating in services under this section will be engaged and involved in the design and implementation of the services4 7#e7 ,an assurance that the applicant will support and integrate existing school-based services with the program in order to provide appropriate mental health services for students4 7#f7 ,an assurance that the applicant will establish a program that will support students and the school in improving the school climate in order to support an environment conducive to learning4 7e7 ,interagency agreements 7#a7 ,designation of lead agency ,a recipient of a grant1 contract1 or cooperative agreement under this section shall designate a lead agency to direct the establishment of an interagency agreement among local educational agencies1 juvenile justice authorities1 mental health agencies1 and other relevant entities in the ,state1 in collaboration with local entities1 such as ,indian tribes4 7#b7 ,contents ,the interagency agreement shall ensure the provision of the services described in subsection 7c71 specifying with respect to each agency1 authority1 or entity-- 7,a7 the financial responsibility for the services2 7,b7 the conditions and terms of responsibility for the services1 including quality1 accountability1 and coordination of the services2 and 7,c7 the conditions and terms of reimbursement among the agencies1 authorities1 or entities that are parties to the interagency agreement1 including procedures for dispute resolution4 7f7 ,evaluation ,the ,secretary shall evaluate each program carried out under this section and shall disseminate the findings with respect to each such evaluation to appropriate public1 tribal1 and private entities4 7g7 ,distribution of awards ,the ,secretary may ensure that grants1 contracts1 and cooperative agreements awarded or entered into under this section are equitably distributed among the geographical regions of the ,united ,states and among tribal1 urban1 suburban1 and rural populations4 7h7 ,rule of construction ,nothing in this section shall be construed-- 7#a7 to prohibit an entity involved with a program carried out under this section from reporting a crime that is committed by a student to appropriate authorities2 or 7#b7 to prevent ,state and tribal law enforcement and judicial authorities from exercising their responsibilities with regard to the application of ,federal1 tribal1 and ,state law to crimes committed by a student4 7i7 ,supplement1 not supplant ,any services provided through programs carried out under this section shall supplement1 and not supplant1 existing mental health services1 including any services required to be provided under the ,individuals with ,disabilities ,education ,act4 7j7 ,consultation with indian tribes ,in carrying out subsection 7a71 the ,secretary shall1 in a timely manner1 meaningfully consult1 engage1 and cooperate with ,indian tribes and their representatives to ensure notice of eligibility4 7k7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #f1jjj1jjj for the period of fiscal years #bjah through #bjbc4 4 ,,iii ,understanding the ,scope of ,trauma ,exposure #cja4 ,,cdc surveillance and data collection for child1 youth1 and adult trauma 7a7 ,data collection ,the ,director of the ,centers for ,disease ,control and ,prevention 7referred to in this section as the ,director7 shall authorize and encourage ,states to collect and report data on adverse childhood experiences through the ,behavioral ,risk ,factor ,surveillance ,system and the ,youth ,risk ,behavior ,surveillance ,system4 ,in collecting and reporting such data1 ,states shall use the appropriate modules developed under section #cjb7b77;,b71 in addition to other appropriate modules4 7b7 ,timing ,the collection of data authorized under subsection 7a7 may occur in fiscal year #bjai and every #b years thereafter4 7c7 ,data from tribal and rural areas ,the ,director shall require that each ,state1 in collecting data in accordance with subsection 7a71 ensure that1 as appropriate1 data from tribal and rural areas within such ,state is included by oversampling from such areas4 7d7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #fd1jjj1jjj for the period of fiscal years #bjai through #bjba4 #cjb4 ,,cdc analysis of child1 youth1 and adult trauma ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall-- 7#a7 conduct an analysis of-- 7,a7 the prevalence of child1 youth1 and adult trauma experienced in the ,united ,states1 including assessments of the types of the most prominent adverse childhood experiences1 and disparities by race and ethnicity1 by geographic distribution1 and by socioeconomic status2 7,b7 the public health impact of adverse childhood experiences1 including the correlation of such experiences with trends in life expectancy and whether the scope of such experiences constitutes a public health epidemic2 7,c7 modules that measure and assess adverse childhood experiences1 for development and ultimate inclusion in the ,youth ,risk ,behavior ,surveillance ,system2 and 7,d7 outcomes modules that measure and evaluate the utilization and efficacy of trauma-informed interventions1 such as mental health services or other clinical or sub-clinical care1 for ultimate inclusion in the ,youth ,risk ,behavior ,surveillance ,system and the ,behavioral ,risk ,factor ,surveillance ,system2 and 7#b7 not later than #a year after the date of enactment of this ,act1 submit to ,congress a report on the analysis under paragraph 7#a7 that includes recommendations on-- 7,a7 what communities can do to mitigate the impact of adverse childhood experiences and how ,indian tribes1 social service providers1 law enforcement1 health care practitioners1 public health agencies1 educational institutions1 and other community stakeholders may collaborate to improve efforts to identify1 connect to appropriate services1 and provide treatment and support for children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 7,b7 modules for inclusion in the appropriate surveillance systems1 as described in subparagraphs 7,c7 and 7,d7 of paragraph 7#a72 and 7,c7 how the ,centers for ,disease ,control and ,prevention can utilize data collected through surveillance systems to target specific populations or geographic locations with a high incidence of measured ,adverse ,childhood ,experiences1 including by considering such data when awarding grants and contracts to entities serving such populations or locations4 #cjc4 ,government accountability study on barriers to and opportunities for trauma-informed identification and treatment 7a7 ,study 7#a7 ,in general ,the ,comptroller ,general shall conduct a study of the barriers to1 and the opportunities for increasing1 the early identification and treatment of children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma4 7#b7 ,contents ,in conducting the study1 the ,comptroller ,general shall examine-- 7,a7 ways in which such identification and treatment could be facilitated in early childhood education and care settings and elementary and secondary schools1 such as through improved teacher preparation1 professional development1 and curriculum design1 and the development of the cognitive and social-emotional skills of students2 7,b7 7i7 the extent to which ,state ,medicaid plans use early and periodic screening1 diagnostic1 and treatment services 7as defined in section #aije7r7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7r77 that are provided in accordance with the requirements of section #aijb7;a77#dc7 of such ,act 7#db ,u4,s4,c4 #acif;a7a77#dc777 to provide trauma-informed services to children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 7ii7 barriers to increased utilization of such screening1 diagnostic1 and treatment services2 and 7iii7 the impact of ,state ,medicaid plan design and ,state regulatory decisions on the provision of such services2 7,c7 the feasibility of1 ,state experiences with1 and considerations regarding1 systematic collection and sharing of data that-- 7i7 is carried out by health care providers1 ,state1 local1 and tribal educational agencies1 social service providers1 law enforcement1 and any other entity providing services in a covered setting 7as defined in section #aja7;f772 7ii7 relies on common data measures1 fosters communication and coordination across covered settings 7as so defined71 and promotes shared accountability for the data2 and 7iii7 relates to the screening1 referral1 and support of children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 7,d7 privacy and consent issues affecting identification and treatment of children and youth who have experienced or are at risk of experiencing trauma1 including considerations regarding information collected and reported by providers and regarding parental consent2 7,e7 7i7 the comprehensive1 coordinated1 and multisector process through which ,state1 local1 and tribal educational agencies locate1 identify1 and screen infants and toddlers with disabilities1 and children with disabilities 7including such children who are youth71 under the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adjj et seq472 and 7ii7 considerations1 strategies1 alignment opportunities1 and applicability for trauma-informed models for conducting such location1 identification1 and screening2 7,f7 7i7 clinical child and adolescent mental health and child- and youth-serving social service workforce capacity1 including analyzing that capacity by setting1 geographic distribution1 and population served2 and 7ii7 barriers that contribute to any shortages in professionals in that workforce2 and 7,g7 the cost-effectiveness and success of providing services through school-based health centers as a method of-- 7i7 addressing the needs of students who have experienced or are at risk of experiencing trauma2 and 7ii7 improving their academic achievement4 7b7 ,report ,the ,comptroller ,general shall submit a report containing the results of the study to-- 7#a7 the ,committee on ,appropriations1 the ,committee on ,health1 ,education1 ,labor1 and ,pensions1 the ,committee on ,finance1 the ,committee on ,indian ,affairs1 and the ,committee on the ,judiciary of the ,senate2 and 7#b7 the ,committee on ,appropriations1 the ,committee on ,energy and ,commerce1 the ,committee on ,education and the ,workforce1 the ,committee on ,ways and ,means1 the ,committee on ,natural ,resources1 and the ,committee on the ,judiciary of the ,house of ,representatives4 7c7 ,definitions ,in this section3 7#a7 ,child with a disability ,the term child with a disability has the meaning given the term in section #fjb of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adja74 7#b7 ,infant or toddler with a disability ,the term infant or toddler with a disability has the meaning given the term in section #fcb of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adcb74 #cjd4 ,,nih report on trauma ,the ,director of the ,national ,institutes of ,health1 not later than #a year after the date of enactment of this ,act1 shall submit to ,congress a report on the activities of the ,national ,institutes of ,health with respect to trauma 7including trauma that stems from child abuse1 exposure to violence1 and toxic stress7 and the implications of trauma for children1 youth1 and adults4 ,such report shall include-- 7#a7 the comprehensive research agenda of the ,national ,institutes of ,health with respect to trauma2 7#b7 the capacity1 expertise1 and review mechanisms of the ,national ,institutes of ,health with respect to the evaluation and examination of research proposals related to child trauma1 including coordination across institutes and centers2 7#c7 the relevance of trauma to other diseases1 outcomes1 and domains2 7#d7 strategies to link and analyze data from multiple independent sources1 including child welfare1 health care 7including mental health care71 law enforcement1 and education systems1 to enhance research efforts and improve health outcomes2 7#e7 the efficacy of existing interventions1 including clinical treatment methods1 child- and family-focused prevention models1 and community-based approaches1 in mitigating the effects of experiencing trauma and improving health and societal outcomes2 and 7#f7 identification of gaps in understanding in the field of trauma and areas of greatest need for further research related to trauma4 ,,iv ,evaluation of new interventions and improving service delivery #dja4 ,clarification of definition of ,medicaid ,,epsdt services2 demonstration project to test trauma-informed delivery of ,,epsdt services 7a7 ,clarification of definition of ,,epsdt services ,section #aije7r7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7r77 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 in subparagraph 7,a77ii71 by inserting 7including in the immediate aftermath of exposure to a traumatic event7 after medically necessary2 and 7,b7 in subparagraph 7,b77i71 by inserting and any past exposure to traumatic events after health development2 and 7#b7 in paragraph 7#e71 by inserting including any defects1 illnesses1 and conditions 7including symptoms of a possible mental health disorder that are not sufficiently acute for a diagnosis of a clinical mental health disorder7 stemming from exposure to traumatic events1 after screening services14 7b7 ,trauma-,informed delivery of ,,epsdt services demonstration project 7#a7 ,in general ,the ,secretary shall make grants to ,states to conduct demonstration projects under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 to test innovative1 trauma-informed approaches for delivering early and periodic screening1 diagnostic1 and treatment services 7as defined in section #aije7r7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7r777 to eligible children4 7#b7 ,scope and duration 7,a7 ,scope ,the ,secretary shall select #aj ,states to participate in the demonstration project4 7,b7 ,selection 7i7 ,diversity ,in selecting ,states to participate in the demonstration project1 the ,secretary shall-- 7,i7 ensure that geographically diverse areas1 including rural and underserved areas1 are included2 and 7,,ii7 include at least #b ,states in which ,indian tribes or tribal organizations 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 are located4 7ii7 ,priority ,in selecting ,states to participate in the demonstration project1 the ,secretary shall give priority to ,states that-- 7,i7 use a value-based payment methodology for paying providers for services provided under the ,state ,medicaid program1 including services related to healthy child development2 7,,ii7 use an alternative payment model under the ,state ,medicaid program that enables cross-sector collaboration1 provision of trauma-informed services1 and supports for healthy child development2 or 7,,iii7 integrate information technology between child- and youth-serving sectors to improve coordination and outcomes4 7,c7 ,duration ,the demonstration project shall begin not later than #a year after the date of the enactment of this ,act1 and shall be conducted for a period of #d years4 7#c7 ,requirements ,to be eligible for a grant under this subsection1 a ,state that is participating in the demonstration project shall demonstrate that it has implemented the following measures with respect to the ,state ,medicaid program3 7,a7 ,the ,state ,medicaid program allows for the provision of early and periodic screening1 diagnostic1 and treatment services-- 7i7 in a diverse set of settings1 including schools1 hospitals1 primary care settings1 ,federally-qualified health centers 7as defined in section #aije7l77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,b7771 and tribally-operated health facilities1 without undue restrictions on the settings in which providers are permitted to furnish such services2 and 7ii7 by the full scope of providers that are licensed or otherwise authorized under ,state law to provide the services1 including trained peers through eligible peer support services1 community health workers1 or subclinical case managers4 7,b7 ,where necessary to improve or promote the health of an eligible child1 the ,state ,medicaid program provides for payment for services provided to the parent of the child4 7,c7 ,the ,state ,medicaid program has procedures in place to coordinate across settings1 which may include coordinating with law enforcement1 juvenile justice agencies1 schools 7including preschools and after-school programs71 hospitals1 primary care providers1 tribally-operated health facilities1 mental health and substance use treatment facilities1 and child welfare providers1 to ensure that eligible children who experience trauma receive the appropriate services4 7,d7 ,where appropriate1 the ,state ,medicaid program coordinates with facilities of the ,indian ,health ,service 7including a hospital1 nursing facility1 or any other type of facility which provides services of a type otherwise covered under the program7 and other tribally-operated health facilities to ensure eligible children have access to adequate qualified providers that are licensed or otherwise authorized under ,state law to furnish the services4 7#d7 ,funding ,out of any funds in the ,treasury not otherwise appropriated1 there is appropriated #ge1jjj1jjj for the period of fiscal years #bjag through #bjba to carry out this subsection4 7#e7 ,definitions ,in this subsection3 7,a7 ,demonstration project ,the term demonstration project means the demonstration project established under this subsection4 7,b7 ,eligible child ,the term eligible child means an individual who is under age #ba and who is enrolled in a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7,c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7,d7 ,state ,medicaid program ,the term ,state ,medicaid program means a ,state plan or waiver under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 #djb4 ,health professional shortage areas ,section #ccb7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7a77 is amended-- 7#a7 in paragraph 7#b77;,a71 by inserting 7including a community health center operated in an elementary or secondary school7 after community health center2 and 7#b7 in paragraph 7#c7-- 7,a7 by striking 1 and residents and inserting 1 residents2 and 7,b7 by inserting 1 and a population group that the ,secretary determines has experienced trauma 7such as through acute or long-term exposure to substantial discrimination1 historical or cultural oppression1 intergenerational poverty1 civil unrest1 a high rate of violence1 or a high rate of drug overdose mortality7 before may be4 #djc4 ,training and certification guidelines for community figures ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,agency for ,healthcare ,research and ,quality1 shall conduct a study on1 and establish guidelines for ,states to consider with respect to1 the training and certification of community figures1 including community mentors1 peers with lived experiences1 and faith-based leaders1 to build awareness of trauma and promote linkages to community services1 provide case management services1 and conduct appropriate trauma-informed screening for individuals who have experienced or are at risk of experiencing trauma4 ,such training and certification guidelines shall include recommendations for experience1 education1 and supervision requirements for1 and partnerships between1 such trained and certified community figures and other health care providers such that the trained and certified community figures may be reimbursed through the ,state ,medicaid plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 for furnishing services to individuals enrolled in such plan4 #djd4 ,training for health care workforce 7a7 ,mental and behavioral health education and training program ,section #gef of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;e-#a7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a71 by inserting 1 trauma1 after focus on child and adolescent mental health2 and 7,b7 in paragraphs 7#b7 and 7#c71 by inserting trauma-informed care and before substance use disorder prevention and treatment services2 and 7#b7 in subsection 7d7-- 7,a7 in paragraph 7#a71 by striking and at the end2 7,b7 in paragraph 7#b71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7#c7 programs with academic study and community practice related to trauma1 its impact on mental and behavioral health outcomes1 and appropriate interventions1 which may include best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 7b7 ,training demonstration program ,section #gfj of such ,act 7#db ,u4,s4,c4 #bidk7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraphs 7#a7 and 7#b71 by inserting trauma-informed after integrate2 and 7,b7 in paragraph 7#c77;,a71 by inserting 1 and recognize and address the impacts of experiencing trauma on children1 youth1 and families before the semicolon2 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#a77;,a7-- 7i7 in clause 7i77,,ii71 by inserting trauma-informed after integrated2 and 7ii7 in clause 7ii77,,iii71 by inserting trauma-informed before treatment2 and 7,b7 in paragraph 7#b77;,a71 by inserting trauma-informed after integrate2 7#c7 in subsection 7c77#a77;,b71 by inserting trauma-informed after integrate2 and 7#d7 in subsection 7d7-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,c71 by striking or at the end2 7ii7 in subparagraph 7,d71 by striking the period and inserting 2 or2 and 7iii7 by adding at the end the following3 7,e7 provide training with academic study and community practice related to trauma1 its impact on mental health outcomes1 and appropriate interventions1 which may include best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 2 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,d71 by striking or at the end2 7ii7 in subparagraph 7,e71 by striking the period and inserting 2 or2 and 7iii7 by adding at the end the following3 7,f7 provide training with academic study and community practice related to trauma1 its impact on mental health outcomes1 and appropriate interventions1 which may include best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 #dje4 ,trauma-related coordinating bodies ,part ,g of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh et seq47 is amended by adding at the end the following3 #ehc4 ,trauma-related coordinating bodies 7a7 ,grants 7#a7 ,in general ,the ,secretary1 acting through the ,administrator1 shall make not more than #bj grants for demonstration projects to ,state1 local1 or tribal eligible entities to act as trauma-related coordinating bodies4 7#b7 ,amount ,the ,secretary shall make such a grant in an amount of not more than #d1jjj1jjj4 7#c7 ,duration ,the ,secretary shall make such a grant for a period of #d years4 7b7 ,eligible entities 7#a7 ,in general ,to be eligible to receive a grant under this section1 an entity shall include #a or more representatives of each of the categories described in paragraph 7#b74 7#b7 ,composition ,the categories referred to in paragraph 7#a7 are-- 7,a7 agencies1 such as public health or child welfare agencies1 that provide services to prevent the impact of trauma among1 identify1 refer for services1 or support 7including providing treatment for7 children and youth1 and their families as appropriate1 that have experienced or are at risk of experiencing trauma2 7,b7 faculty at an institution of higher education1 or researchers or experts1 in an area related to prevention of the impact of1 identification of1 referral for services for1 or support 7including treatment7 for child and youth trauma2 7,c7 hospitals or other health care institutions1 such as mental health and substance use treatment facilities2 7,d7 law enforcement2 7,e7 elementary or secondary schools1 or early childhood education or care programs2 7,f7 community-based faith1 human services1 or social services organizations1 including providers of after-school programs1 home visiting programs1 or programs to prevent or address the impact of violence2 and 7,g7 the general public1 including individuals who have experienced trauma4 7#c7 ,qualifications ,in order for an entity to be eligible to receive the grant1 the representatives included in the entity shall1 collectively1 have professional training and expertise concerning a broad range of adverse childhood experiences4 7c7 ,application ,to be eligible to receive a grant under this section1 an entity shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require1 including information describing how the coordinating body will continue its activities after the end of the grant period4 7d7 ,priority ,in making grants under this section1 the ,secretary shall give priority to entities proposing to serve communities that have faced trauma due to substantial discrimination1 historical or cultural oppression1 intergenerational poverty1 civil unrest1 a high rate of violence1 or a high rate of drug overdose mortality4 7e7 ,use of funds ,an entity that receives a grant under this section to act as a coordinating body shall use the grant funds-- 7#a7 to bring together stakeholders who provide or use services in1 or have expertise concerning1 covered settings to identify community needs and resources related to services to prevent or address the impact of trauma1 and to build on any needs assessments conducted by organizations or groups represented on the coordinating body2 7#b7 7,a7 to collect data1 on indicators specified by the ,secretary1 that covers multiple covered settings2 and 7,b7 to use the data to identify unique community challenges1 gaps in services1 and high-need areas1 related to services to prevent or address the impact of trauma2 7#c7 to build awareness1 skills1 and leadership 7including through trauma-informed training and public outreach campaigns7 related to implementing the best practices developed under section #aja of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag 7referred to in this subsection as the developed best practices72 7#d7 to pool resources of the members of the organizations and groups represented on the coordinating body1 related to implementing the developed best practices2 and 7#e7 to develop a strategic plan that identifies-- 7,a7 barriers to and gaps in the provision of services to prevent or address the impact of trauma2 and 7,b7 policy goals and coordination opportunities 7including coordination in applying for grants7 relating to implementing the developed best practices4 7f7 ,supplement not supplant ,amounts made available under this section shall be used to supplement and not supplant other ,federal1 ,state1 and local public funds and private funds expended to provide trauma-related coordination activities4 7g7 ,evaluation ,at the end of the period for which grants are made under this section1 the ,secretary shall conduct an evaluation of the activities carried out under each grant under this section4 ,in conducting the evaluation1 the ,secretary shall assess the outcomes of the grant activities carried out by each grant recipient4 7h7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #hj1jjj1jjj for the period of fiscal years #bjah through #bjba4 7i7 ,definition ,in this section1 the term covered setting has the meaning given the term in section #aja7;f7 of the ,trauma-,informed ,care for ,children and ,families ,act of #bjag4 4 #djf4 ,expansion of performance partnership pilot for children who have experienced or are at risk of experiencing trauma ,section #ebf of the ,departments of ,labor1 ,health and ,human ,services1 and ,education1 and ,related ,agencies ,appropriations ,act1 #bjad 7#db ,u4,s4,c4 #abcja note7 is amended-- 7#a7 in subsection 7a71 by adding at the end the following3 7#d7 ,to improve outcomes for children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma means to increase the rate at which individuals who have experienced or are at risk of experiencing trauma1 including those who are low-income1 homeless1 in foster care1 involved in the juvenile justice system1 unemployed1 or not enrolled in or at risk of dropping out of an educational institution and live in a community that has faced acute or long-term exposure to substantial discrimination1 historical oppression1 intergenerational poverty1 civil unrest1 or a high rate of violence1 achieve success in meeting educational1 employment1 health1 developmental1 community reentry1 or other key goals4 2 7#b7 in subsection 7b7-- 7,a7 in the subsection heading1 by striking fiscal year #bjad and inserting fiscal years #bjah through #bjbb2 7,b7 by redesignating paragraphs 7#a7 and 7#b7 as subparagraphs 7,a7 and 7,b71 respectively1 and by moving such subparagraphs1 as so redesignated1 #b ems to the right2 7,c7 by striking ,federal agencies and inserting the following3 7#a7 ,disconnected youth pilots ,federal agencies 2 and 7,d7 by adding at the end the following3 7#b7 ,trauma-informed care pilots ,federal agencies may use ,federal discretionary funds that are made available in this ,act or any ,act appropriating funds for any of fiscal years #bjah through #bjbb to carry out up to #aj ,performance ,partnership ,pilots4 ,such ,pilots shall-- 7,a7 be designed to improve outcomes for children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 and 7,b7 involve ,federal programs targeted on children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma4 2 7#c7 in subsection 7c77#b77;,a71 by striking #bjah and inserting #bjbb2 and 7#d7 in subsection 7e71 by striking #bjah and inserting #bjbb4 #djg4 ,trauma-informed teaching 7a7 ,partnership grants ,section #bjb of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajbb;a7 is amended-- 7#a7 in subsection 7b77#f7-- 7,a7 by redesignating subparagraphs 7,h7 through 7,k7 as subparagraphs 7,i7 through 7,l71 respectively2 and 7,b7 by inserting after subparagraph 7,g7 the following3 7,h7 how the partnership will prepare general education and special education teachers to work with students who have experienced trauma 7including students who are involved in the foster care or juvenile justice systems or runaway or homeless youth7 and in alternative education settings in which high populations of youth with trauma exposure may learn 7including settings for correctional education1 juvenile justice1 pregnant and parenting students1 or youth who have re-entered school after a period of absence due to dropping out72 2 7#b7 in subsection 7d77#a77;,a77i7-- 7,a7 in subclause 7,,ii71 by striking and at the end2 7,b7 by redesignating subclause 7,,iii7 as subclause 7,,iv72 and 7,c7 by inserting after subclause 7,,ii7 the following3 7,,iii7 such teachers to adopt evidence-based approaches for improving behavior 7such as positive behavior interventions and supports and restorative justice71 supporting social and emotional learning1 mitigating the effects of trauma1 improving the learning environment in the school1 and for reducing the need for suspensions1 expulsions1 corporal punishment1 referrals to law enforcement1 and other actions that remove students from instruction2 and 2 and 7#c7 in subsection 7d71 by adding at the end the following3 7#g7 ,trauma-informed practice and work in alternative education settings ,developing the teaching skills of prospective and1 as applicable1 new elementary school and secondary school teachers to adopt evidence-based trauma-informed teaching strategies-- 7,a7 to-- 7i7 recognize the signs of trauma and its impact on learning2 7ii7 maximize student engagement2 and 7iii7 minimize suspension and expulsion2 and 7,b7 including programs training teachers to work with students with exposure to traumatic events 7including students involved in the foster care or juvenile justice systems7 and in alternative academic settings for youth unable to participate in a traditional public school program in which high populations of students with trauma exposure may learn 7such as students involved in the foster care or juvenile justice systems1 pregnant and parenting students1 runaway and homeless students1 and other youth who have re-entered school after a period of absence due to dropping out74 4 7b7 ,administrative provisions ,section #bjc7;b77#b7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajbb;b7b77#b77 is amended-- 7#a7 in subparagraph 7,a71 by striking and at the end2 7#b7 in subparagraph 7,b71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7,c7 to eligible partnerships that have a high-quality proposal for trauma training programs for general education and special education teachers4 4