Sec. 3. Data analysis and strategy implementation to prevent and mitigate childhood trauma
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Title XXXI of the Public Health Service Act ( 42 U.S.C. 300kk ) is amended by adding at the end the following: The Secretary shall establish a program— to support the development and implementation of programs that use data analysis methods to identify and facilitate strategies for early intervention and prevention, in order to prevent and mitigate childhood trauma and support communities and families, including— improving connections through care coordination; aligning community initiatives in targeted areas of need; and expanding community capacity through cross-sector collaboration; and to evaluate the effectiveness of these programs in improving outcomes for children.
The Secretary shall award grants to up to 5 eligible entities to carry out the activities described in subsection (a). 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 prevention, in order to prevent and mitigate childhood trauma and support communities and families, including as follows: Utilize data analysis methods to— identify specific geographic areas, such as census tracts, with a high prevalence of adverse childhood experiences and significant risk factors for poor outcomes for children (such as increased risk of experiencing adverse childhood experiences), including areas with high rates of— poor public health outcomes including illness, disease, suicide, and mortality; exclusionary discipline practices, including suspensions, expulsions, and referrals to law enforcement, as well as low graduation rates; substance use disorders; poverty; foster system involvement or referrals; housing instability and homelessness; food insecurity; inequity, including disparities in income, wealth, employment, educational attainment, health care access, and public health outcomes, along lines of race, sex, sexuality and gender identity, ethnicity, or nationality; incarceration rates; or other indicators of adversity as defined by the Secretary; and identify strategies to improve outcomes for children aged 0 through 17 that build on strengths in communities that could be further supported, including— existing support networks for families; and enhanced connections to community-based organizations.
Implement strategies identified pursuant to paragraph (1)(B) to facilitate outreach and involvement of children and their caregivers in Federal, State, or local programs that provide reparative, gender-responsive, culturally specific, and trauma-informed prevention services, and for which children and their caregivers are eligible, including— home visiting programs; training and education on parenting skills; substance use disorder prevention and treatment that is voluntary and noncoercive; mental health supports and care that is voluntary and noncoercive; family and intimate partner violence prevention services; child advocacy center programming; economic and nutrition support services; housing support services, including emergency and temporary shelter for those experiencing homelessness and housing insecurity, as well as stable, long-term housing; voluntary, noncoercive, gender-responsive, and culturally specific mental health supports in school and early childhood education center-based settings; wraparound programs for transitioning youth and youth currently in the foster system; programming to support the health and well-being of lesbian, gay, bisexual, transgender, and intersex children and their families; and family resource center services.
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— will enter into agreements with public or nonprofit private entities under which the entities will provide the service; and demonstrate that the State and all eligible subdivisions will ensure that the entities providing the service— will seek payment for each such service rendered in accordance with the usual payment schedule under the State plan; and the entities have entered into a participation agreement and are qualified to receive payments under such plan.
An eligible entity that receives a grant under this section may use— not more than 25 percent of the amounts made available through the grant for the first 24 months of the grant period to utilize data analysis methods to— identify specific geographic areas where care coordination, prevention and early intervention, and facilitation services will be provided; and identify support and intervention services to improve outcomes for children located in a geographic area identified under subsection (c)(1)(A); and not more than 10 percent of the grant in each subsequent year to continue data analysis activities.
An eligible entity that receives a grant under this section may not use more than 5 percent of amounts received through the grant for administration, reporting, and program oversight functions, including the development of systems to improve data collection and data sharing for the purposes of improving services and the provision of care. In awarding grants under this section, the Secretary shall give priority, to the extent practical, to eligible entities that use community-based system dynamic modeling as the primary data analysis method.
The term system dynamic modeling means a method of data analysis and predictive modeling that includes— utilization of community-based participatory research methods for involving community in the process of understanding and changing systems and evaluating outcomes of grants; 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 outcomes, including— maltreatment cases; involvement with the juvenile criminal legal system or foster system; exclusionary school discipline; or exposure to violence; and identification of cross-sector responses involving reparative, trauma-informed, culturally specific, gender-responsive, and community-based organizations to reduce adverse child outcomes.
An eligible entity that receives a grant under this section shall use at least 25 percent of the total amount of the grant to make subgrants to organizations that aide in implementing the strategy identified under subsection (c)(1)(B) for preventing and mitigating childhood trauma and supporting communities and families. To be eligible to receive a subgrant under this paragraph, an organization shall prepare and submit to the eligible entity an application in such form, and containing such information, as the eligible entity may require, including evidence that the— needs of the population to be served are urgent and are not met by the services currently available in the geographic area; and the organization has the capacity to provide the services listed in subsection (c)(2).
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 (c)(2). To be eligible to receive a grant under this section, an eligible entity shall submit to the Secretary an application in such form, and containing such information, as the Secretary may require, to include the following: A demonstration that— the applicant utilizes trauma-informed, culturally specific, and gender-responsive practices, including a demonstration of the extent to which the applicant has trained staff in these practices; the applicant has the capacity to administer the grant, including conducting all required data analysis activities; and services will be provided to children and families in an accessible, culturally relevant, and linguistically specific manner consistent with local needs.
A preliminary analysis of how the applicant will use the grant to— identify the geographic area or areas to be served using data analysis methods; utilize data analysis methods to identify strategies to improve outcomes for children in the geographic area; facilitate strategies identified through care coordination efforts; and track data for evaluation of outcomes. A detailed project plan for the use of the grant that includes anticipated technical assistance needs. Additional funding sources, including State and local funds, supporting the prevention and mitigation of adverse childhood experiences.
The amount of a grant under this section shall not exceed $9,500,000. The period of a grant under this section shall not exceed 7 years. As a condition on receipt of a grant under this section, an eligible entity shall agree that any assistance provided to an individual through the grant will be provided without regard to— the ability of the individual to pay for such services; the current or past health condition of the individual to be served; the immigration status of the individual to be served; the sexual orientation and gender identity of the individual to be served; and any prior involvement of the individual in the criminal legal system.
In addition to any other prohibitions determined by the Secretary, an eligible entity may not use a grant under this section to— use data analysis methods to inform individual case decisions, including child removal or placement decisions, or to target services at certain individuals or families; 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 eligible; increase the presence or funding of law enforcement surveillance, involvement, or activity in implementing the strategies identified under subsection (c)(1)(B); or enable the practice of conversion therapy.
Not later than 36 months after the date of enactment of this section, the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services, in coordination with the grantees receiving a grant under this section, shall complete an evaluation of the effectiveness of the data model accuracy of the grant program under this section to address each of the following: Determining the effectiveness of the grantees’ use of data analysis methods to identify geographic areas pursuant to subsection (c)(1).
Examining the grantees’ development and utilization of data analysis methods. Examining the grantees’ ability to effectively utilize data analysis methods in future prevention work. 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 demographics. Examining the grantees’ utilization of community-based system dynamics modeling methods and other community engagement methods.
Not later than 6 years after the date of enactment of this section, the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services, in coordination with eligible entities receiving grants under this section, shall complete an evaluation of the effectiveness of the grant program under this section. 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
(1)and
(2)to include— the activities funded by the grant under this section, including development and implementation data analysis methods; the number of children and of families receiving coordination and facilitation of care and services; and the effect of activities supported by the grant under this section on the local area serviced by the program, including such effects on— children and adolescents’ health and well-being; the number of children who enter into or depart from foster services; and homelessness and housing insecurity. Not later than 7 years after the date of enactment of this section, the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services shall— complete a study on the results of the grant program under this section using the community-based participatory action research method, which focuses on social, structural, and physical environmental inequities through active involvement of community members, clients, organizational representatives, and researchers in all aspects of the research process; and submit a report on the results of the study to the Congress. In conducting the study under clause (i), 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 level, especially those such partners or persons receiving services and support through the program, have an opportunity to contribute their expertise to evaluating the strategy and outcomes. Not later than three months after the completion of the evaluation required by subsection (j)(2), 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 (j)(2), to include— the impact of the program under this section on homelessness and housing insecurity, substance use disorder and drug deaths, incarceration, foster system involvement, and other child and family outcomes as identified by the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services; an analysis of which elements of the program should be replicated and scaled by governmental or non-governmental entities; and such recommendations for legislation and administrative action as the Secretary determines appropriate. In this section: 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 outcomes, such as any of the following: Abuse, such as any of the following: Emotional and psychological abuse. Physical abuse. Sexual abuse. Household challenges such as any of the following: A household member is treated violently. A household member has a substance use disorder. A household member has a mental health condition. Parental separation or divorce. A household member is incarcerated, placed in immigrant detention, or has been deported. A household member has a life-threatening illness such as COVID–19. Neglect. Living in— impoverished communities that lack access to human services; areas of high unemployment neighborhoods; or communities experiencing de facto segregation. Experiencing food insecurity and poor nutrition. Witnessing violence. Involvement with the foster system. Experiencing discrimination. Dealing with historical and ongoing traumas due to systemic and interpersonal racism. Dealing with historical and ongoing traumas regarding systemic and interpersonal sexism, homophobia, biphobia, and transphobia. Dealing with the threat of deportation or detention as a result of immigration status. The impacts of multigenerational poverty resulting from limited educational and economic opportunities. Living through natural disasters such as earthquakes, forest fires, floods, or hurricanes. The term eligible entity means a State or local health department. The term practice of conversion therapy — means any practice or treatment by any person that seeks to change another individual’s sexual orientation or gender identity, including efforts to change behaviors or gender expressions, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender, if such person receives monetary compensation in exchange for any such practice or treatment; and does not include any practice or treatment that does not seek to change sexual orientation or gender identity and— provides assistance to an individual undergoing a gender transition; or provides acceptance, support, and understanding of a client or facilitation of a client’s coping, social support, and identity exploration and development. There is authorized to be appropriated to carry out this section for the period of fiscal years 2020 through 2027— to carry out subsection (a)(1) through the award of grants under subsection (b)— $47,500,000 for grants; and such sums as may be necessary for the administrative costs of carrying out such subsection; and $7,500,000 to carry out the evaluation under subsection (a)(2). .
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Sec. 3
Data analysis and strategy implementation to prevent and mitigate childhood trauma
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