Sec. 3. Standards and enforcement
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Not later than 180 days after the date of enactment of this Act, the Secretary shall require each covered program in a State, in order to provide for the basic health and safety of children at such a program and in order for the State to remain eligible as described in section 114(b) of the Child Abuse Prevention and Treatment Act (as added by section 7 of this Act), to meet the following minimum standards: Child abuse and neglect shall be prohibited. Disciplinary techniques or other practices that involve the withholding of essential food, water, clothing, shelter, or medical care necessary to maintain physical health, mental health, and general safety, shall be prohibited.
Acts of physical or mental abuse designed to humiliate or degrade a child, or undermine a child’s self-respect, shall be prohibited. The use of seclusion, mechanical restraints, and physical restraints that impair breathing or communication shall be prohibited. Physical restraints other than the restraints described in clause
(i)may be used (if not contraindicated) only in emergency situations in which a child presents an imminent danger of harm to self or others and only after less restrictive interventions have been determined to be ineffective. Each child at such a program— shall have reasonable access to a telephone and means for electronic and written communications, and be informed of the child's right to such access, to maintain frequent contact with parents or guardians, including making, sending, and receiving scheduled and unscheduled calls, unrestricted written correspondence, and electronic communications, with as much privacy as possible; and shall have access to current and appropriate national, State, and local hotline numbers for reporting child abuse and neglect. The program shall have appropriate ratios of medical, clinical, and line staff members to children, as determined by the Secretary, to ensure child safety and the efficacy of treatment. Not less than one full-time licensed clinician or mental health practitioner shall be employed as a senior manager of the program. Not less than one licensed clinician shall be present at all times for the program. The licensed clinician may be on call unless having such a clinician physically present is necessary to ensure safety and clinically appropriate care. The program shall have policies to require— parents or guardians of a child attending such a program to notify, in writing, such program of any medication the child is taking; a full-time licensed clinician— to obtain consent from the parents or guardians of the child to make any change to the child’s medical treatment, except in the case of an emergency; in the case of an emergency, to notify the parents or guardians within 24 hours after any change to the child’s medical treatment, to describe the change and the reason for such change; and to notify the parents or guardians within 24 hours after any change to the child’s prescribed medication or any occurrence of a missed dose of prescribed medication, to describe the change or occurrence and the reason for such change or occurrence; and the covered program to notify parents or guardians of a child of any change to the program's treating provider team within 48 hours after the change. The program shall have procedures for notifying immediately, to the maximum extent practicable, but not later than 6 hours after the occurrence involved, parents or guardians of a child at such a program and the appropriate protection and advocacy system of any occurrence of an— onsite investigation of a report of child abuse and neglect; violation of a standard described in any of subparagraphs
(A)through (D); and violation of a State licensing requirement. Full disclosure, in writing, of staff member qualifications and their roles and responsibilities at such a program, including any medical, emergency response, and mental health training received by such staff members, shall be given to parents or guardians of children at such a program. Full disclosure, in writing, of the private right of action established under subsection (b)(3), shall be given to parents or guardians of children at such a program. Each staff member at such a program shall be required, as a condition of employment, to become trained in the acts and omissions that constitute child abuse and neglect, State law relating to mandated reporters, and procedures for reporting child abuse and neglect, in the State in which the program is located, and information on current and appropriate national, State, and local hotline numbers for reporting child abuse and neglect. Each staff member at such a program shall be required, as a condition of employment, to become trained in recognizing the signs, symptoms, and appropriate responses associated with common medical emergencies and mental health crises, including warning signs of suicide and worsening symptoms of mental illness. Each staff member for such a program shall be required, as a condition of employment, to submit to a criminal history check, including a name-based search of the National Sex Offender Registry established pursuant to the Adam Walsh Child Protection and Safety Act of 2006 ( 42 U.S.C. 16901 et seq. ), a search of the State criminal registry or repository in the State in which the covered program is operating, and a Federal Bureau of Investigation fingerprint check. An individual shall be ineligible to serve in a position with any contact with children at a covered program if any such criminal history check reveals a conviction for a violent felony that, by virtue of its nature, proximity in time, or other factor, is likely to directly increase a child’s risk of harm in the program as determined by the Secretary. The covered program shall provide an independent process through which a staff member who is determined to be ineligible for employment as a result of a criminal history check under clause
(i)shall have the right— to obtain a copy of the report resulting from the check; and within 10 business days after receipt of the report, to appeal, in order to dispute the accuracy of the information obtained through the check. Full disclosure, in writing, in promotional and informational materials produced by a covered program, shall be given to parents or guardians of children at such a program, which shall include disclosure of— the name and location of the program, including the names of any owners and operators; the number and percentage of children who terminated participation prior to completion of that program in the past 5 years, including children discharged against medical advice; any past violations of the standards required under this paragraph by the program and any penalties levied against the program as a result of such violations; its current status (current as of the date the materials were given to the parents or guardians) with respect to State licensing requirements; the number of deaths that occurred in that program during the most recent 10-year period and the cause of each death; the names of owners and operators of the program that have violated State licensing requirements; information on evidence-based or promising practices employed as treatment in the covered program, and information to aid parents and guardians in finding community-based treatment resources; and any national, State, and local telephone hotline numbers that the program made available to children and staff members to report complaints of child abuse and neglect, or a violation of this paragraph, by the program. The entity carrying out the covered program shall work with the parents or guardians of a child of the program and the child’s community-based providers in the development, modification, and implementation of treatment and discharge plans, including a plan for community reintegration and linkage to community-based providers and supports. The entity carrying out the program shall ensure that no person shall, on the basis of actual or perceived race, color, religion, national origin, sex, gender identity, sexual orientation, or disability, be subjected to discrimination in the provision of any program or activity, in whole or in part, covered by this Act. The entity carrying out the program shall ensure that the program employs safe, evidence-based practices, and that children are protected against harmful or fraudulent practices, including use of isolation or of mechanical restraints or physical restraints. The program shall meet any other standard the Secretary determines appropriate to provide for the basic health and safety of children at a covered program. Not later than 180 days after the date of enactment of this Act, the Secretary shall promulgate and enforce interim regulations to carry out paragraph (1). The Secretary shall, for a 90-day period beginning on the date of the promulgation of interim regulations under subparagraph (A), solicit and accept public comment concerning such regulations. Such public comment shall be submitted in written form. Not later than 90 days after the conclusion of the 90-day period referred to in subparagraph (B), the Secretary shall promulgate and enforce final regulations to carry out paragraph (1). Not later than 180 days after the date of enactment of this Act, the Secretary shall implement a review process for overseeing, investigating, and evaluating reports, of child abuse and neglect at covered programs, that are received by the Secretary from the appropriate State, in accordance with paragraph
(4)or
(5)of section 114(b) of the Child Abuse Prevention and Treatment Act, as added by section 7 of this Act. Such review process shall— include an investigation to determine if a violation of the standards required under subsection (a)(1) has occurred; and include consultation and collaboration with relevant Federal and State agencies. Not later than 180 days after the date of enactment of this Act, the Secretary shall promulgate regulations establishing civil penalties for violations of the standards required under subsection (a)(1). The regulations establishing such penalties shall incorporate the following: Any owner or operator of a covered program at which the Secretary has found a violation of the standards required under subsection (a)(1) may be assessed a civil penalty not to exceed $50,000 per violation. All penalties collected under this paragraph shall be deposited in the appropriate account of the Treasury of the United States. Any person who suffers injury by reason of a violation of subsection (a)(1) may bring a civil action against the alleged violator to obtain appropriate compensatory damages and injunctive relief or other equitable relief. The Secretary shall establish a process to assist States in the oversight and enforcement of this Act, which shall include— assisting States in implementing oversight mechanisms to ensure compliance of covered programs in the States with the standards required under subsection (a)(1); maintaining oversight of covered programs in a State, in a case in which a State has not established, within 3 years after the date of the enactment of this Act, mechanisms sufficient to ensure compliance of such programs with the standards required under subsection (a)(1); and encouraging the use by States of national, State, or local hotline numbers for reporting child abuse and neglect and any other resources the Secretary determines to be appropriate.
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Sec. 3
Standards and enforcement
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