Sec. 4. Care coordination grants

2,404 words·~11 min read·/bill/116/hr/8544/ih/section-4

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Part E of title XII of the Public Health Service Act ( 42 U.S.C. 300d–51 et seq.) is amended by adding at the end the following new section: The Secretary shall award grants to eligible entities to establish or expand trauma-informed care coordination services to support— children aged 0 through 5 at risk of adverse childhood experiences; and their caregivers, including prenatal people of any age. Subject to the availability of appropriations, the Secretary shall award not fewer than 9 and not more than 40 grants under this section.

Subject to the availability of appropriations, the amount of a grant under this section for a fiscal year shall be— not less than $250,000; and not more than $1,000,000. To be eligible to receive a grant under this section, an entity shall be a local government or Indian Tribe, acting through the public health department thereof if such government or Tribe has a public health department. In awarding grants under this section, the Secretary shall give priority to eligible entities proposing to serve communities with a high need for trauma-informed care coordination services, as demonstrated by indicators such as— pregnant people who face barriers to prenatal care; mortality or morbidity of people giving birth or infants; caretakers and parents who are living with a mental health condition or substance use disorder; a high prevalence of community violence, including domestic violence, as demonstrated by instances of homicide and public health statistics, including treatment of injury or trauma; high proportions of low-income children; a high prevalence of child fatalities or near fatalities related to child abuse and neglect; significant disparities in health outcomes for people giving birth and infants; a high rate of exclusionary discipline and referrals to law enforcement; and a high rate of homelessness and housing instability.

The Secretary, acting through the Director of the Indian Health Service, shall consult with Indian Tribes to establish criteria to measure indicators of need, for purposes of paragraph (1), with respect to Tribal areas. A grant received under this section shall be used to establish or expand gender-responsive, culturally specific, trauma-informed care coordination services, including by instituting and conducting risk and needs assessments including— using strengths-based approaches focused on protective factors for children and their caregivers, including prenatal people of any age; and inputting screening results into a centralized intake system to promote a single point of access system across providers and services.

A grant received under this section shall be used to ensure that individuals employed through the grant funds, in whole or in part, have received sufficient and up-to-date training on trauma-informed care and strategies that are reparative, culturally sensitive, gender-responsive, and healing-centered. A grant received under this section may be used for any of the following: Employing care coordinators, case managers, community health workers, certified infant mental health specialists, and outreach and engagement specialists to work with children and their caregivers, including prenatal individuals, to prevent and respond to adverse childhood experiences by connecting clients with culturally specific, trauma-informed care treatment services, including economic, social, food, and housing supports.

Providing training described in paragraph (1)(B) to community health providers and community partners. Expanding, enhancing, modifying, and connecting the existing network of community programs and services to achieve a more comprehensive and coordinated system of care approach, including— developing local infrastructure to bolster and shape community support systems and map and build access to services in a coordinated and comprehensive way; and creating infrastructure to conduct outreach to children and families, including those experiencing homelessness and housing instability, so they acquire access to the services and supports they need and the benefits to which they are entitled.

Compiling information on resources (including any referral services) available through community-based organizations and local, State, and Federal agencies, such as— programs addressing social determinants of health, including— emergency, temporary, and long-term housing; programs that offer free or affordable and nutritious food; vocational and workforce development; and transportation supports; home visiting programs for new parents and their infants; workforce development programs to support caregivers in skill building; trauma-responsive, parenting skills-building programs; the continuum of substance use prevention, intervention, and treatment programs and mental health support programs, including programs with trauma-informed, gender-responsive, and culturally specific counseling; and childcare support and early childhood education, including Head Start and Early Head Start programs.

Subject to subsection (g)(2), establishing or updating a database that compiles data used to track the effectiveness of the care coordination services funded through the grant. Developing and implementing referral partnership agreements with community-based organizations, parent organizations, substance use disorder treatment providers and facilities, housing and shelter providers, health care providers, mental health care providers, and Federal and State offices and programs that implement practices to support children ages 0 through 5 who are at risk of adverse childhood experiences and their caregivers, including prenatal people.

Such practices shall include— a bilateral warm handoff system whereby a grantee understands the needs of the children and their families, and families are involved in addressing these needs; and 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 contact. Supporting cross-system planning and collaboration among employees who may work in emergency medical services, health care services, public health, early childhood education, and substance use disorder treatment and recovery support.

Providing or subsidizing services to address barriers that children, prenatal individuals, and caregivers face to utilizing community resources and services, such as by providing or subsidizing transportation or childcare costs as applicable and within reasonable amounts. Creating or expanding infrastructure and investing in technology, including the provision of communications technology and internet service to children and their caregivers, to enable increased telemedicine capabilities to reach participants.

In the case of an eligible entity that is an Indian tribe, the Secretary may waive such provisions of this subsection as the Secretary determines appropriate. 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; or increase the presence or funding of law enforcement surveillance, involvement, or activity in connection with trauma-informed care coordination services supported pursuant to this section.

As a condition on receipt of a grant under this section, an eligible entity shall agree to each of the following funding conditions: The eligible entity will not use more than 30 percent of the funds made available to the entity through the grant (for the total grant period) to establish or update a database pursuant to subsection (f)(2)(E). The eligible entity will ensure that all care coordination services provided through the grant are provided in a setting that is accessible, including through mobile settings, to— low-income or no-income individuals, including individuals experiencing homelessness or housing instability; and individuals in rural areas.

In complying with subparagraph (A), the eligible entity will ensure that at least 50 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 served, such as homes, schools, and shelters, whether for initial outreach or as part of long-term care. The grant will be used to supplement not supplant other Federal, State, or local funds available for care coordination services.

The eligible entity will maintain the confidentiality of individuals receiving services through the grant in a manner consistent with applicable law. In providing care coordination services through the grant, the eligible entity will— partner with community-based organizations with experience serving child populations prenatally through age 5; coordinate with the local agency responsible for administering the State plan approved under title XIX of the Social Security Act; and employ risk stratification to develop different effective models of care for different populations based on their needs.

To seek a grant under this section, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information, as the Secretary may require. An application under paragraph

(1)shall, at a minimum, contain each of the following: Goals to be achieved through the grant, including the activities that will be undertaken to achieve those goals. The number of individuals likely to be served through the grant, including demographic data on the populations to be served. Existing programs and services that can be used to significantly increase the proportion of children and families who receive needed supports and services. A plan for expanding, coordinating, 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 experiences. A demonstration of the ability of the eligible entity to reach the individuals to be served, including by partnering with local stakeholders. An indication of how the personnel involved are reflective of the communities to be served. A list of stakeholders with whom the entity plans to partner or consult. Not later than 4 years after the date of enactment of this section, an eligible entity receiving a grant under this section shall submit to the Secretary a report on the activities funded through the grant. Such report shall include, at a minimum, a description of— the number of individuals served through activities funded through the grant, including demographics as applicable; the number of referrals made through the grant and the rate of such referrals successfully linked or closed; a qualitative analysis or number of collaborative partnerships with other organizations in carrying out the activities funded through the grant; the number of services provided to individuals through the grant; aggregated and de-identified outcomes experienced by individuals served through the grant such as— the rate of successful service connections; any increases in development of protective factors for children; any increase in development of protective factors for the caregivers; any mitigation of the negative outcomes associated with adverse childhood experiences or decreased likelihood of children experiencing an adverse childhood experience as evidenced by— decreased presence of law enforcement or other punitive State surveillance in the community; a parent completing substance use treatment; a parent receiving voluntary treatment for mental health-related conditions; a family entering into or maintaining a stable housing situation; a family achieving or maintaining economic security; a parent achieving or maintaining job stability; or a child meeting developmental markers for school readiness; and reports of satisfaction with the coordination of care by people served; and any other information required by the Secretary. After the period of all grants awarded under this section has concluded, 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— lessons learned; challenges experienced; and ideas for next steps and solutions. After providing the opportunity required by subsection (j), the Secretary shall— compile the findings and conclusions of grantees under this section on the provision of care coordination services described in subsection (a); submit a report on such findings and conclusions to the appropriate congressional committees; and make such report publicly available. 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 care coordination means an active, ongoing process that— assists children ages 0 through 5 at risk of, or who have experienced, an adverse childhood experience, and their caregivers, including prenatal people of any age, to identify, access, and use community resources and services; is client-centered and comprehensive of the services a child or caregiver may need; ensures a closed loop referral by obtaining feedback from the families served; and works across systems and services to promote collaboration to effectively meet the needs of community members. The term Indian Tribe has the meaning given such term in section 4 of the Indian Self-Determination and Education Assistance Act. 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 relationships. To carry out this section, there is authorized to be appropriated $15,000,000 for each of the 5 fiscal years following the fiscal year in which this section is enacted. Of the amount made available to carry out this section for a fiscal year, the Secretary shall use not less than 10 percent of such amount for grants to eligible entities that are Indian tribes. Of the amount made available to carry out this section for a fiscal year, the Secretary may use not more than 15 percent of such amount for administrative expenses, including the expenses of the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services for compiling and reporting information. Of the amount made available to carry out this section for a fiscal year, the Secretary may reserve up to 5 percent of such amount to provide technical assistance to eligible entities in preparing and submitting applications under this section. .

Connections1 off-index

1 reference not yet in our index

42 USC 300d–51

Citation graph

cites case law

Sec. 4

Care coordination grants

Cite42 USC 300d–51

Cites 1Cited by 0 across 0 sources