,i #aafth ,,congress #b;d ,session ,h4 ,r4 #hedd ,,in ,,the ,,house ,,of ,,representatives ,october #f1 #bjbj,ms4 ,pressley 7for herself and ,mrs4 ,carolyn ,b4 ,maloney of ,new ,york7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act to support the development and implementation of programs using data analysis to identify and facilitate strategies to improve outcomes for children in geographic areas with a high prevalence of trauma from exposure to adverse childhood experiences1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,services and ,trauma-informed ,research of ,outcomes in ,neighborhoods ,grants for ,support for ,children ,act of #bjbj or the ,,strong ,support for ,children ,act of #bjbj4 #b4 ,findings ,congress finds that-- 7#a7 childhood trauma is a pervasive public health issue with long-term negative effects that costs the ,united ,states thousands of lives and billions of dollars2 7#b7 addressing childhood and adolescent trauma requires a comprehensive ,federal approach that recognizes its severe impact and prioritizes trauma-informed prevention and treatment that is reparative1 healing-centered1 gender-responsive1 culturally specific1 and community-based2 7#c7 adults who have suffered from adverse childhood experiences are at much greater risk of death1 including as the result of heart disease1 lung disease1 cancer1 substance use disorder1 and suicide2 7#d7 childhood and adolescent exposures to adverse childhood experiences are generational and persistent and can lead to complex trauma and toxic stress impacting brain development and triggering epigenetics2 7#e7 any ,federal effort to prevent and treat trauma must acknowledge and address the impact of historic and systemic causal factors1 which include1 but are not limited to1 the trauma of-- 7,a7 historical and ongoing systemic racism1 sexism1 xenophobia1 homophobia1 transphobia1 and ableism that have led to generations of violence and injustice and have robbed communities of their health1 freedom1 and peace of mind2 7,b7 police brutality1 racial profiling1 and criminalization1 as well as heightened police activity and surveillance in some areas with higher police-reported crime1 whether as a result of community violence or of racial profiling2 7,c7 poverty and other systemic inequities1 including lack of health care1 housing instability1 poor housing conditions1 hunger and food instability and the accompanying malnutrition1 and environmental injustice resulting from generations of racist policies1 historic redlining1 lending discrimination1 and workplace discrimination2 7,d7 gender-based violence1 including sexual harassment and assault and discriminatory school discipline policies1 especially for ,black girls and girls of color2 7,e7 western colonization and systemic divestment in native communities2 7,f7 family separation policies1 including zero-tolerance immigration enforcement policies that have resulted in the deportation or the threat of deportation for countless immigrant families and have led to community mistrust and fear of reporting injustices2 and 7,g7 war and military presence1 including the increased militarization of local1 ,state1 and ,federal law enforcement agencies2 and 7#f7 the ,,covid-#ai global health pandemic has increased and exacerbated the trauma inflicted on young people1 specifically young people who-- 7,a7 live in communities with higher rates of infection and mortality2 7,b7 have parents who are essential workers or first responders2 7,c7 have parents who have lost their sources of income2 7,d7 have witnessed death2 7,e7 have had their education interrupted2 7,f7 are living without access to green space and space for physical exercise2 7,g7 have become housing insecure and lack access to nutritious food2 and 7,h7 are isolated amidst increased domestic violence and sexual assault4 #c4 ,data analysis and strategy implementation to prevent and mitigate childhood trauma ,title ,,xxxi of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjkk7 is amended by adding at the end the following3 #cajb4 ,data analysis and strategy implementation to prevent and mitigate childhood trauma 7a7 ,in general ,the ,secretary shall establish a program-- 7#a7 to support the development and implementation of programs that use data analysis methods to identify and facilitate strategies for early intervention and prevention1 in order to prevent and mitigate childhood trauma and support communities and families1 including-- 7,a7 improving connections through care coordination2 7,b7 aligning community initiatives in targeted areas of need2 and 7,c7 expanding community capacity through cross-sector collaboration2 and 7#b7 to evaluate the effectiveness of these programs in improving outcomes for children4 7b7 ,grants ,the ,secretary shall award grants to up to #e eligible entities to carry out the activities described in subsection 7a74 7c7 ,use of funds ,a grant for activities under this section shall be used to support the development and implementation of programs that use data analysis methods to identify and facilitate strategies for early intervention and prevention1 in order to prevent and mitigate childhood trauma and support communities and families1 including as follows3 7#a7 ,utilize data analysis methods to-- 7,a7 identify specific geographic areas1 such as census tracts1 with a high prevalence of adverse childhood experiences and significant risk factors for poor outcomes for children 7such as increased risk of experiencing adverse childhood experiences71 including areas with high rates of-- 7i7 poor public health outcomes including illness1 disease1 suicide1 and mortality2 7ii7 exclusionary discipline practices1 including suspensions1 expulsions1 and referrals to law enforcement1 as well as low graduation rates2 7iii7 substance use disorders2 7iv7 poverty2 7v7 foster system involvement or referrals2 7vi7 housing instability and homelessness2 7vii7 food insecurity2 7viii7 inequity1 including disparities in income1 wealth1 employment1 educational attainment1 health care access1 and public health outcomes1 along lines of race1 sex1 sexuality and gender identity1 ethnicity1 or nationality2 7ix7 incarceration rates2 or 7x7 other indicators of adversity as defined by the ,secretary2 and 7,b7 identify strategies to improve outcomes for children aged #j through #ag that build on strengths in communities that could be further supported1 including-- 7i7 existing support networks for families2 and 7ii7 enhanced connections to community-based organizations4 7#b7 ,implement strategies identified pursuant to paragraph 7#a77;,b7 to facilitate outreach and involvement of children and their caregivers in ,federal1 ,state1 or local programs that provide reparative1 gender-responsive1 culturally specific1 and trauma-informed prevention services1 and for which children and their caregivers are eligible1 including-- 7,a7 home visiting programs2 7,b7 training and education on parenting skills2 7,c7 substance use disorder prevention and treatment that is voluntary and noncoercive2 7,d7 mental health supports and care that is voluntary and noncoercive2 7,e7 family and intimate partner violence prevention services2 7,f7 child advocacy center programming2 7,g7 economic and nutrition support services2 7,h7 housing support services1 including emergency and temporary shelter for those experiencing homelessness and housing insecurity1 as well as stable1 long-term housing2 7,i7 voluntary1 noncoercive1 gender-responsive1 and culturally specific mental health supports in school and early childhood education center-based settings2 7,j7 wraparound programs for transitioning youth and youth currently in the foster system2 7,k7 programming to support the health and well-being of lesbian1 gay1 bisexual1 transgender1 and intersex children and their families2 and 7,l7 family resource center services4 7d7 ,special rules 7#a7 ,primary payer restriction ,the ,secretary may not award a grant under this section to an eligible entity for a service if the service to be provided is available pursuant to the ,state plan approved under title ,,xix of the ,social ,security ,act for the ,state in which the program funded by the grant is being conducted unless the ,state and all eligible subdivisions involved-- 7,a7 will enter into agreements with public or nonprofit private entities under which the entities will provide the service2 and 7,b7 demonstrate that the ,state and all eligible subdivisions will ensure that the entities providing the service-- 7i7 will seek payment for each such service rendered in accordance with the usual payment schedule under the ,state plan2 and 7ii7 the entities have entered into a participation agreement and are qualified to receive payments under such plan4 7#b7 ,implementation ,an eligible entity that receives a grant under this section may use-- 7,a7 not more than #be percent of the amounts made available through the grant for the first #bd months of the grant period to utilize data analysis methods to-- 7i7 identify specific geographic areas where care coordination1 prevention and early intervention1 and facilitation services will be provided2 and 7ii7 identify support and intervention services to improve outcomes for children located in a geographic area identified under subsection 7c77#a77;,a72 and 7,b7 not more than #aj percent of the grant in each subsequent year to continue data analysis activities4 7#c7 ,administration ,an eligible entity that receives a grant under this section may not use more than #e percent of amounts received through the grant for administration1 reporting1 and program oversight functions1 including the development of systems to improve data collection and data sharing for the purposes of improving services and the provision of care4 7#d7 ,priority 7,a7 ,in general ,in awarding grants under this section1 the ,secretary shall give priority1 to the extent practical1 to eligible entities that use community-based system dynamic modeling as the primary data analysis method4 7,b7 ,system dynamic modeling defined ,the term system dynamic modeling means a method of data analysis and predictive modeling that includes-- 7i7 utilization of community-based participatory research methods for involving community in the process of understanding and changing systems and evaluating outcomes of grants2 7ii7 consideration of a multitude of environmental risk factors and ascertainment of the significance of contributing community risk factors for purposes of identifying strategies to reduce adverse child outcomes1 including-- 7,i7 maltreatment cases2 7,,ii7 involvement with the juvenile criminal legal system or foster system2 7,,iii7 exclusionary school discipline2 or 7,,iv7 exposure to violence2 and 7iii7 identification of cross-sector responses involving reparative1 trauma-informed1 culturally specific1 gender-responsive1 and community-based organizations to reduce adverse child outcomes4 7#e7 ,subgrant 7,a7 ,in general ,an eligible entity that receives a grant under this section shall use at least #be percent of the total amount of the grant to make subgrants to organizations that aide in implementing the strategy identified under subsection 7c77#a77;,b7 for preventing and mitigating childhood trauma and supporting communities and families4 7,b7 ,eligibility ,to be eligible to receive a subgrant under this paragraph1 an organization shall prepare and submit to the eligible entity an application in such form1 and containing such information1 as the eligible entity may require1 including evidence that the-- 7i7 needs of the population to be served are urgent and are not met by the services currently available in the geographic area2 and 7ii7 the organization has the capacity to provide the services listed in subsection 7c77#b74 7,c7 ,supplement not supplant ,subgrant funds received pursuant to this paragraph by an organization shall be used to supplement and not supplant ,state or local funds provided to the partnership organization for services listed in subsection 7c77#b74 7e7 ,application ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary an application in such form1 and containing such information1 as the ,secretary may require1 to include the following3 7#a7 ,a demonstration that-- 7,a7 the applicant utilizes trauma-informed1 culturally specific1 and gender-responsive practices1 including a demonstration of the extent to which the applicant has trained staff in these practices2 7,b7 the applicant has the capacity to administer the grant1 including conducting all required data analysis activities2 and 7,c7 services will be provided to children and families in an accessible1 culturally relevant1 and linguistically specific manner consistent with local needs4 7#b7 ,a preliminary analysis of how the applicant will use the grant to-- 7,a7 identify the geographic area or areas to be served using data analysis methods2 7,b7 utilize data analysis methods to identify strategies to improve outcomes for children in the geographic area2 7,c7 facilitate strategies identified through care coordination efforts2 and 7,d7 track data for evaluation of outcomes4 7#c7 ,a detailed project plan for the use of the grant that includes anticipated technical assistance needs4 7#d7 ,additional funding sources1 including ,state and local funds1 supporting the prevention and mitigation of adverse childhood experiences4 7f7 ,grant amount ,the amount of a grant under this section shall not exceed #i1ejj1jjj4 7g7 ,period of a grant ,the period of a grant under this section shall not exceed #g years4 7h7 ,service provision without regard to ability ,to pay ,as a condition on receipt of a grant under this section1 an eligible entity shall agree that any assistance provided to an individual through the grant will be provided without regard to-- 7#a7 the ability of the individual to pay for such services2 7#b7 the current or past health condition of the individual to be served2 7#c7 the immigration status of the individual to be served2 7#d7 the sexual orientation and gender identity of the individual to be served2 and 7#e7 any prior involvement of the individual in the criminal legal system4 7i7 ,prohibitions ,in addition to any other prohibitions determined by the ,secretary1 an eligible entity may not use a grant under this section to-- 7#a7 use data analysis methods to inform individual case decisions1 including child removal or placement decisions1 or to target services at certain individuals or families2 7#b7 require any individual or family to participate in any service or program as a condition of receipt of a benefit to which the individual or family is otherwise eligible2 7#c7 increase the presence or funding of law enforcement surveillance1 involvement1 or activity in implementing the strategies identified under subsection 7c77#a77;,b72 or 7#d7 enable the practice of conversion therapy4 7j7 ,evaluation 7#a7 ,data model evaluation ,not later than #cf months after the date of enactment of this section1 the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services1 in coordination with the grantees receiving a grant under this section1 shall complete an evaluation of the effectiveness of the data model accuracy of the grant program under this section to address each of the following3 7,a7 ,determining the effectiveness of the grantees' use of data analysis methods to identify geographic areas pursuant to subsection 7c77#a74 7,b7 ,examining the grantees' development and utilization of data analysis methods4 7,c7 ,examining the grantees' ability to effectively utilize data analysis methods in future prevention work4 7,d7 ,establishing a method for rigorously evaluating the activities of grantees and comparing the reduction of child and family exposure to adverse experiences in other communities with similar demographics4 7,e7 ,examining the grantees' utilization of community-based system dynamics modeling methods and other community engagement methods4 7#b7 ,program evaluation ,not later than #f years after the date of enactment of this section1 the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services1 in coordination with eligible entities receiving grants under this section1 shall complete an evaluation of the effectiveness of the grant program under this section4 7#c7 ,data ,collection 7,a7 ,in general ,the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services and each eligible entity receiving a grant under this section shall collect any relevant data necessary to complete the evaluations required by paragraphs 7#a7 and 7#b7 to include-- 7i7 the activities funded by the grant under this section1 including development and implementation data analysis methods2 7ii7 the number of children and of families receiving coordination and facilitation of care and services2 and 7iii7 the effect of activities supported by the grant under this section on the local area serviced by the program1 including such effects on-- 7,i7 children and adolescents' health and well-being2 7,,ii7 the number of children who enter into or depart from foster services2 and 7,,iii7 homelessness and housing insecurity4 7,b7 ,study 7i7 ,in general ,not later than #g years after the date of enactment of this section1 the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services shall-- 7,i7 complete a study on the results of the grant program under this section using the community-based participatory action research method1 which focuses on social1 structural1 and physical environmental inequities through active involvement of community members1 clients1 organizational representatives1 and researchers in all aspects of the research process2 and 7,,ii7 submit a report on the results of the study to the ,congress4 7ii7 ,partners ,in conducting the study under clause 7i71 the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services shall ensure that partners and persons that have participated in the grant program under this section on every level1 especially those such partners or persons receiving services and support through the program1 have an opportunity to contribute their expertise to evaluating the strategy and outcomes4 7k7 ,report ,not later than three months after the completion of the evaluation required by subsection 7j77#b71 the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services shall submit to ,congress and make available to the public on the internet website of the ,department of ,health and ,human ,services a report based upon the evaluation under subsection 7j77#b71 to include-- 7#a7 the impact of the program under this section on homelessness and housing insecurity1 substance use disorder and drug deaths1 incarceration1 foster system involvement1 and other child and family outcomes as identified by the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services2 7#b7 an analysis of which elements of the program should be replicated and scaled by governmental or non-governmental entities2 and 7#c7 such recommendations for legislation and administrative action as the ,secretary determines appropriate4 7l7 ,definition ,in this section3 7#a7 ,the term adverse childhood experience means a potentially traumatic experience that occurs in childhood and can have a tremendous impact on the child's lifelong health and opportunity outcomes1 such as any of the following3 7,a7 ,abuse1 such as any of the following3 7i7 ,emotional and psychological abuse4 7ii7 ,physical abuse4 7iii7 ,sexual abuse4 7,b7 ,household challenges such as any of the following3 7i7 ,a household member is treated violently4 7ii7 ,a household member has a substance use disorder4 7iii7 ,a household member has a mental health condition4 7iv7 ,parental separation or divorce4 7v7 ,a household member is incarcerated1 placed in immigrant detention1 or has been deported4 7vi7 ,a household member has a life-threatening illness such as ,,covid-#ai4 7,c7 ,neglect4 7,d7 ,living in-- 7i7 impoverished communities that lack access to human services2 7ii7 areas of high unemployment neighborhoods2 or 7iii7 communities experiencing de facto segregation4 7,e7 ,experiencing food insecurity and poor nutrition4 7,f7 ,witnessing violence4 7,g7 ,involvement with the foster system4 7,h7 ,experiencing discrimination4 7,i7 ,dealing with historical and ongoing traumas due to systemic and interpersonal racism4 7,j7 ,dealing with historical and ongoing traumas regarding systemic and interpersonal sexism1 homophobia1 biphobia1 and transphobia4 7,k7 ,dealing with the threat of deportation or detention as a result of immigration status4 7,l7 ,the impacts of multigenerational poverty resulting from limited educational and economic opportunities4 7,m7 ,living through natural disasters such as earthquakes1 forest fires1 floods1 or hurricanes4 7#b7 ,the term eligible entity means a ,state or local health department4 7#c7 ,the term practice of conversion therapy-- 7,a7 means any practice or treatment by any person that seeks to change another individual's sexual orientation or gender identity1 including efforts to change behaviors or gender expressions1 or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender1 if such person receives monetary compensation in exchange for any such practice or treatment2 and 7,b7 does not include any practice or treatment that does not seek to change sexual orientation or gender identity and-- 7i7 provides assistance to an individual undergoing a gender transition2 or 7ii7 provides acceptance1 support1 and understanding of a client or facilitation of a client's coping1 social support1 and identity exploration and development4 7m7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section for the period of fiscal years #bjbj through #bjbg-- 7#a7 to carry out subsection 7a77#a7 through the award of grants under subsection 7b7-- 7,a7 #dg1ejj1jjj for grants2 and 7,b7 such sums as may be necessary for the administrative costs of carrying out such subsection2 and 7#b7 #g1ejj1jjj to carry out the evaluation under subsection 7a77#b74 4 #d4 ,care coordination grants ,part ,e of title ,,xii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;d-#ea et seq47 is amended by adding at the end the following new section3 #abee4 ,care coordination grants 7a7 ,in general ,the ,secretary shall award grants to eligible entities to establish or expand trauma-informed care coordination services to support-- 7#a7 children aged #j through #e at risk of adverse childhood experiences2 and 7#b7 their caregivers1 including prenatal people of any age4 7b7 ,number of grants ,subject to the availability of appropriations1 the ,secretary shall award not fewer than #i and not more than #dj grants under this section4 7c7 ,amount of grants ,subject to the availability of appropriations1 the amount of a grant under this section for a fiscal year shall be-- 7#a7 not less than #bej1jjj2 and 7#b7 not more than #a1jjj1jjj4 7d7 ,eligible entities ,to be eligible to receive a grant under this section1 an entity shall be a local government or ,indian ,tribe1 acting through the public health department thereof if such government or ,tribe has a public health department4 7e7 ,priority 7#a7 ,in general ,in awarding grants under this section1 the ,secretary shall give priority to eligible entities proposing to serve communities with a high need for trauma-informed care coordination services1 as demonstrated by indicators such as-- 7,a7 pregnant people who face barriers to prenatal care2 7,b7 mortality or morbidity of people giving birth or infants2 7,c7 caretakers and parents who are living with a mental health condition or substance use disorder2 7,d7 a high prevalence of community violence1 including domestic violence1 as demonstrated by instances of homicide and public health statistics1 including treatment of injury or trauma2 7,e7 high proportions of low-income children2 7,f7 a high prevalence of child fatalities or near fatalities related to child abuse and neglect2 7,g7 significant disparities in health outcomes for people giving birth and infants2 7,h7 a high rate of exclusionary discipline and referrals to law enforcement2 and 7,i7 a high rate of homelessness and housing instability4 7#b7 ,data from ,tribal areas ,the ,secretary1 acting through the ,director of the ,indian ,health ,service1 shall consult with ,indian ,tribes to establish criteria to measure indicators of need1 for purposes of paragraph 7#a71 with respect to ,tribal areas4 7f7 ,use of funds 7#a7 ,required uses 7,a7 ,in general ,a grant received under this section shall be used to establish or expand gender-responsive1 culturally specific1 trauma-informed care coordination services1 including by instituting and conducting risk and needs assessments including-- 7i7 using strengths-based approaches focused on protective factors for children and their caregivers1 including prenatal people of any age2 and 7ii7 inputting screening results into a centralized intake system to promote a single point of access system across providers and services4 7,b7 ,training ,a grant received under this section shall be used to ensure that individuals employed through the grant funds1 in whole or in part1 have received sufficient and up-to-date training on trauma-informed care and strategies that are reparative1 culturally sensitive1 gender-responsive1 and healing-centered4 7#b7 ,permissible uses ,a grant received under this section may be used for any of the following3 7,a7 ,employing care coordinators1 case managers1 community health workers1 certified infant mental health specialists1 and outreach and engagement specialists to work with children and their caregivers1 including prenatal individuals1 to prevent and respond to adverse childhood experiences by connecting clients with culturally specific1 trauma-informed care treatment services1 including economic1 social1 food1 and housing supports4 7,b7 ,providing training described in paragraph 7#a77;,b7 to community health providers and community partners4 7,c7 ,expanding1 enhancing1 modifying1 and connecting the existing network of community programs and services to achieve a more comprehensive and coordinated system of care approach1 including-- 7i7 developing local infrastructure to bolster and shape community support systems and map and build access to services in a coordinated and comprehensive way2 and 7ii7 creating infrastructure to conduct outreach to children and families1 including those experiencing homelessness and housing instability1 so they acquire access to the services and supports they need and the benefits to which they are entitled4 7,d7 ,compiling information on resources 7including any referral services7 available through community-based organizations and local1 ,state1 and ,federal agencies1 such as-- 7i7 programs addressing social determinants of health1 including-- 7,i7 emergency1 temporary1 and long-term housing2 7,,ii7 programs that offer free or affordable and nutritious food2 7,,iii7 vocational and workforce development2 and 7,,iv7 transportation supports2 7ii7 home visiting programs for new parents and their infants2 7iii7 workforce development programs to support caregivers in skill building2 7iv7 trauma-responsive1 parenting skills-building programs2 7v7 the continuum of substance use prevention1 intervention1 and treatment programs and mental health support programs1 including programs with trauma-informed1 gender-responsive1 and culturally specific counseling2 and 7vi7 childcare support and early childhood education1 including ,head ,start and ,early ,head ,start programs4 7,e7 ,subject to subsection 7g77#b71 establishing or updating a database that compiles data used to track the effectiveness of the care coordination services funded through the grant4 7,f7 ,developing and implementing referral partnership agreements with community-based organizations1 parent organizations1 substance use disorder treatment providers and facilities1 housing and shelter providers1 health care providers1 mental health care providers1 and ,federal and ,state offices and programs that implement practices to support children ages #j through #e who are at risk of adverse childhood experiences and their caregivers1 including prenatal people4 ,such practices shall include-- 7i7 a bilateral warm handoff system whereby a grantee understands the needs of the children and their families1 and families are involved in addressing these needs2 and 7ii7 an active service connection whereby the children and families are each actively connected with a resource in a well-coordinated way that ensures availability and direct contact4 7,g7 ,supporting cross-system planning and collaboration among employees who may work in emergency medical services1 health care services1 public health1 early childhood education1 and substance use disorder treatment and recovery support4 7,h7 ,providing or subsidizing services to address barriers that children1 prenatal individuals1 and caregivers face to utilizing community resources and services1 such as by providing or subsidizing transportation or childcare costs as applicable and within reasonable amounts4 7,i7 ,creating or expanding infrastructure and investing in technology1 including the provision of communications technology and internet service to children and their caregivers1 to enable increased telemedicine capabilities to reach participants4 7#c7 ,indian tribes ,in the case of an eligible entity that is an ,indian tribe1 the ,secretary may waive such provisions of this subsection as the ,secretary determines appropriate4 7#d7 ,prohibitions ,in addition to any other prohibitions determined by the ,secretary1 an eligible entity may not use a grant under this section to-- 7,a7 use data analysis methods to inform individual case decisions1 including child removal or placement decisions1 or to target services at certain individuals or families2 7,b7 require any individual or family to participate in any service or program as a condition of receipt of a benefit to which the individual or family is otherwise eligible2 or 7,c7 increase the presence or funding of law enforcement surveillance1 involvement1 or activity in connection with trauma-informed care coordination services supported pursuant to this section4 7g7 ,requirements ,as a condition on receipt of a grant under this section1 an eligible entity shall agree to each of the following funding conditions3 7#a7 ,restriction of funding allocation ,the eligible entity will not use more than #cj percent of the funds made available to the entity through the grant 7for the total grant period7 to establish or update a database pursuant to subsection 7f77#b77;,e74 7#b7 ,accessible setting 7,a7 ,in general ,the eligible entity will ensure that all care coordination services provided through the grant are provided in a setting that is accessible1 including through mobile settings1 to-- 7i7 low-income or no-income individuals1 including individuals experiencing homelessness or housing instability2 and 7ii7 individuals in rural areas4 7,b7 ,community outreach ,in complying with subparagraph 7,a71 the eligible entity will ensure that at least #ej percent of the care coordination services provided through the grant occur in community settings that are convenient to the children and caregivers who are being served1 such as homes1 schools1 and shelters1 whether for initial outreach or as part of long-term care4 7#c7 ,supplement not supplant ,the grant will be used to supplement not supplant other ,federal1 ,state1 or local funds available for care coordination services4 7#d7 ,confidentiality ,the eligible entity will maintain the confidentiality of individuals receiving services through the grant in a manner consistent with applicable law4 7#e7 ,partnering2 risk stratification ,in providing care coordination services through the grant1 the eligible entity will-- 7,a7 partner with community-based organizations with experience serving child populations prenatally through age #e2 7,b7 coordinate with the local agency responsible for administering the ,state plan approved under title ,,xix of the ,social ,security ,act2 and 7,c7 employ risk stratification to develop different effective models of care for different populations based on their needs4 7h7 ,application 7#a7 ,in general ,to seek a grant under this section1 an eligible entity shall submit an application to the ,secretary at such time1 in such manner1 and containing such information1 as the ,secretary may require4 7#b7 ,contents ,an application under paragraph 7#a7 shall1 at a minimum1 contain each of the following3 7,a7 ,goals to be achieved through the grant1 including the activities that will be undertaken to achieve those goals4 7,b7 ,the number of individuals likely to be served through the grant1 including demographic data on the populations to be served4 7,c7 ,existing programs and services that can be used to significantly increase the proportion of children and families who receive needed supports and services4 7,d7 ,a plan for expanding1 coordinating1 or modifying the existing network of programs and services to meet the needs of children and families for preventing and mitigating the traumatic impact of adverse childhood experiences4 7,e7 ,a demonstration of the ability of the eligible entity to reach the individuals to be served1 including by partnering with local stakeholders4 7,f7 ,an indication of how the personnel involved are reflective of the communities to be served4 7,g7 ,a list of stakeholders with whom the entity plans to partner or consult4 7i7 ,reporting by grantees ,not later than #d years after the date of enactment of this section1 an eligible entity receiving a grant under this section shall submit to the ,secretary a report on the activities funded through the grant4 ,such report shall include1 at a minimum1 a description of-- 7#a7 the number of individuals served through activities funded through the grant1 including demographics as applicable2 7#b7 the number of referrals made through the grant and the rate of such referrals successfully linked or closed2 7#c7 a qualitative analysis or number of collaborative partnerships with other organizations in carrying out the activities funded through the grant2 7#d7 the number of services provided to individuals through the grant2 7#e7 aggregated and de-identified outcomes experienced by individuals served through the grant such as-- 7,a7 the rate of successful service connections2 7,b7 any increases in development of protective factors for children2 7,c7 any increase in development of protective factors for the caregivers2 7,d7 any mitigation of the negative outcomes associated with adverse childhood experiences or decreased likelihood of children experiencing an adverse childhood experience as evidenced by-- 7i7 decreased presence of law enforcement or other punitive ,state surveillance in the community2 7ii7 a parent completing substance use treatment2 7iii7 a parent receiving voluntary treatment for mental health-related conditions2 7iv7 a family entering into or maintaining a stable housing situation2 7v7 a family achieving or maintaining economic security2 7vi7 a parent achieving or maintaining job stability2 or 7vii7 a child meeting developmental markers for school readiness2 and 7,e7 reports of satisfaction with the coordination of care by people served2 and 7#f7 any other information required by the ,secretary4 7j7 ,convening participants for sharing lessons learned ,after the period of all grants awarded under this section has concluded1 the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services shall provide an in-person or online opportunity for persons participating in the programs funded through this section to share with each other-- 7#a7 lessons learned2 7#b7 challenges experienced2 and 7#c7 ideas for next steps and solutions4 7k7 ,compiling findings and conclusions ,after providing the opportunity required by subsection 7j71 the ,secretary shall-- 7#a7 compile the findings and conclusions of grantees under this section on the provision of care coordination services described in subsection 7a72 7#b7 submit a report on such findings and conclusions to the appropriate congressional committees2 and 7#c7 make such report publicly available4 7l7 ,definitions ,in this section3 7#a7 ,adverse childhood experience ,the term adverse childhood experience means a potentially traumatic experience that occurs in childhood and can have a tremendous impact on the child's lifelong health and opportunity outcomes1 such as any of the following3 7,a7 ,abuse1 such as any of the following3 7i7 ,emotional and psychological abuse4 7ii7 ,physical abuse4 7iii7 ,sexual abuse4 7,b7 ,household challenges such as any of the following3 7i7 ,a household member is treated violently4 7ii7 ,a household member has a substance use disorder4 7iii7 ,a household member has a mental health condition4 7iv7 ,parental separation or divorce4 7v7 ,a household member is incarcerated1 placed in immigrant detention1 or has been deported4 7vi7 ,a household member has a life-threatening illness such as ,,covid-#ai4 7,c7 ,neglect4 7,d7 ,living in-- 7i7 impoverished communities that lack access to human services2 7ii7 areas of high unemployment neighborhoods2 or 7iii7 communities experiencing de facto segregation4 7,e7 ,experiencing food insecurity and poor nutrition4 7,f7 ,witnessing violence4 7,g7 ,involvement with the foster system4 7,h7 ,experiencing discrimination4 7,i7 ,dealing with historical and ongoing traumas due to systemic and interpersonal racism4 7,j7 ,dealing with historical and ongoing traumas regarding systemic and interpersonal sexism1 homophobia1 biphobia1 and transphobia4 7,k7 ,dealing with the threat of deportation or detention as a result of immigration status4 7,l7 ,the impacts of multigenerational poverty resulting from limited educational and economic opportunities4 7,m7 ,living through natural disasters such as earthquakes1 forest fires1 floods1 or hurricanes4 7#b7 ,care coordination ,the term care coordination means an active1 ongoing process that-- 7,a7 assists children ages #j through #e at risk of1 or who have experienced1 an adverse childhood experience1 and their caregivers1 including prenatal people of any age1 to identify1 access1 and use community resources and services2 7,b7 is client-centered and comprehensive of the services a child or caregiver may need2 7,c7 ensures a closed loop referral by obtaining feedback from the families served2 and 7,d7 works across systems and services to promote collaboration to effectively meet the needs of community members4 7#c7 ,indian ,tribe ,the term ,indian ,tribe has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#d7 ,protective factors ,the term protective factors refers to any supportive element in a child or caretaker's life that helps the child or caretaker to withstand trauma such as a stable school environment or supportive peer relationships4 7m7 ,authorization of appropriations 7#a7 ,in general ,to carry out this section1 there is authorized to be appropriated #ae1jjj1jjj for each of the #e fiscal years following the fiscal year in which this section is enacted4 7#b7 ,grants to ,indian tribes ,of the amount made available to carry out this section for a fiscal year1 the ,secretary shall use not less than #aj percent of such amount for grants to eligible entities that are ,indian tribes4 7#c7 ,administrative expenses ,of the amount made available to carry out this section for a fiscal year1 the ,secretary may use not more than #ae percent of such amount for administrative expenses1 including the expenses of the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services for compiling and reporting information4 7#d7 ,technical assistance ,of the amount made available to carry out this section for a fiscal year1 the ,secretary may reserve up to #e percent of such amount to provide technical assistance to eligible entities in preparing and submitting applications under this section4 4