[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2846 Introduced in Senate (IS)]
<DOC>
115th CONGRESS
2d Session
S. 2846
To provide for multidisciplinary teams for military installations on
child abuse and other domestic violence, to require a pilot program on
nurse home visits to reduce child abuse and improve safe childcare
among military families, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 15, 2018
Mrs. Gillibrand (for herself and Mr. Tillis) introduced the following
bill; which was read twice and referred to the Committee on Armed
Services
_______________________________________________________________________
A BILL
To provide for multidisciplinary teams for military installations on
child abuse and other domestic violence, to require a pilot program on
nurse home visits to reduce child abuse and improve safe childcare
among military families, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Military Family Prevention,
Response, and Other Training to End Military Family Abuse and Connect
Communities Today Act'' or ``Military Family PROTECT Act''.
SEC. 2. MULTIDISCIPLINARY TEAMS FOR MILITARY INSTALLATIONS ON CHILD
ABUSE AND OTHER DOMESTIC VIOLENCE.
(a) Multidisciplinary Teams Required.--
(1) In general.--Under regulations prescribed by each
Secretary concerned, there shall be established and maintained
for each military installation, except as provided in paragraph
(2), one or more multidisciplinary teams on child abuse and
other domestic violence for the purposes specified in
subsection (b).
(2) Single team for proximate installations.--A single
multidiscipinary team described in paragraph (1) may be
established and maintained under this subsection for two or
more military installations in proximity with one another if
the Secretary concerned determines, in consultation with the
Secretary of Defense, that a single team for such installations
suffices to carry out the purposes of such teams under
subsection (b) for such installations.
(b) Purposes.--The purposes of each multidisciplinary team
maintained pursuant to subsection (a) shall be as follows:
(1) To provide for the sharing of information among such
team and other appropriate personnel on the installation or
installations concerned regarding the progress of
investigations into and resolutions of incidents of child abuse
and other domestic violence involving members of the Armed
Forces stationed at or otherwise assigned to the installation
or installations.
(2) To provide for and enhance collaborative efforts among
such team and other appropriate personnel of the installation
or installations regarding investigations into and resolutions
of such incidents.
(3) To enhance the social services available to military
families at the installation or installations in connection
with such incidents, including through the enhancement of
cooperation among specialists and other personnel providing
such services to such military families in connection with such
incidents.
(4) To carry out such other duties regarding the response
to child abuse and other domestic violence at the installation
or installations as the Secretary concerned considers
appropriate for such purposes.
(c) Personnel.--
(1) In general.--Each multidisciplinary team maintained
pursuant to subsection (a) shall be composed of the following:
(A) One or more judge advocates.
(B) Appropriate personnel of one or more military
criminal investigation services.
(C) Appropriate mental health professionals.
(D) Appropriate medical personnel.
(E) Family advocacy case workers.
(F) Such other personnel as the Secretary or
Secretaries concerned consider appropriate.
(2) Expertise and training.--Any individual assigned to a
multidisciplinary team shall possess such expertise, and shall
undertake such training as is required to maintain such
expertise, as the Secretary concerned shall specify for
purposes of this section in order to ensure that members of the
team remain appropriately qualified to carry out the purposes
of the team under this section. The training and expertise so
specified shall include training and expertise on special
victims' crimes, including child abuse and other domestic
violence.
(d) Ongoing Responsibilities.--Each multidisciplinary team
maintained pursuant to subsection (a) shall do the following:
(1) Meet on a regular basis to review ongoing cases.
(2) Undertake training of team members on their various
disciplines, including through the use of civilian experts to
provide such training.
(3) Enter into memoranda of understanding among team
members regarding team goals, to define roles and
responsibilities of team members (including goals of training),
to specify the frequency and schedule of team meetings, to
ensure protection of confidentiality in team activities, and to
specify protocols and procedures for notification and response
to incidents of child abuse and other domestic violence
(including reporting to local civilian authorities) and the use
of child forensic interviews, forensic medical examinations,
safety measures, and support services in connection with such
incidents.
(e) Coordination and Collaboration With Non-Military Resources.--
(1) Use of community resources serving installations.--In
providing under this section for a multidisciplinary team for a
military installation or installations that benefit from
services or resources on child abuse or other domestic violence
that are provided by civilian entities in the vicinity of the
installation or installations, the Secretary concerned may take
the availability of such services or resources to the
installation or installations into account in providing for the
composition and duties of the team.
(2) Best practices.--The Secretaries concerned shall take
appropriate actions to ensure that multidisciplinary teams
maintained pursuant to subsection (a) remain fully and
currently apprised of best practices in the civilian sector on
investigations into and resolutions of incidents of child abuse
and other domestic violence and on the social services provided
in connection with such incidents.
(3) Collaboration.--In providing for the enhancement of
social services available to military families in accordance
with subsection (b)(3), the Secretaries concerned shall permit,
facilitate, and encourage multidisciplinary teams to
collaborate with appropriate civilian agencies in the vicinity
of the military installations concerned with regard to
availability, provision, and use of such services to and by
such families.
(f) Annual Report.--Not later than February 28 each year, each
Secretary concerned shall submit to Congress a report on the activities
of multidisciplinary teams maintained pursuant to subsection (a) under
the jurisdiction of such Secretary during the preceding year. Each
report shall set forth, for the period covered by such report, the
following:
(1) A summary description of the activities of the
multidisciplinary teams concerned, including the number and
composition of such teams, the recurring activities of such
teams, and any notable achievements of such teams.
(2) A description of any impediments to the effectiveness
of such teams.
(3) Such recommendations for legislative or administrative
action as such Secretary considers appropriate in order to
improve the effectiveness of such teams.
(4) Such other matters with respect to such teams as such
Secretary considers appropriate.
(g) Multidisciplinary Team Within OSD.--
(1) In general.--The Secretary of Defense shall establish
and maintain within the Office of the Secretary of Defense a
multidisciplinary team on child abuse and other domestic
violence within the Department of Defense. The team shall
consist of at least one representative of each Armed Force and
such other personnel as the Secretary shall specify.
(2) Duties.--The multidisciplinary team maintained pursuant
to this subsections shall do the following:
(A) Identify and make recommendations on policies
to address child abuse and other domestic violence.
(B) Identify and disseminate best practices in
connection with the purposes of multidisciplinary teams
maintained pursuant to subsection (a).
(C) Meet on a regular basis in order to--
(i) review and assess the activities and
effectiveness of multidisciplinary teams
maintained pursuant to subsection (a); and
(ii) in light of such review and
assessment, make recommendations for
improvements and enhancements of such teams and
the authorities and activities of such teams.
(D) Carry out such other activities as the
Secretary of Defense considers appropriate.
(h) Secretary Concerned.--
(1) Definition.--In this section, the term ``Secretary
concerned'' has the meaning given that term in section
101(a)(9) of title 10, United States Code.
(2) Usage with respect to multiple installations.--For
purposes of this section, any reference to ``Secretary
concerned'' with respect to a single multidisciplinary team
established and maintained pursuant to subsection (a) for two
or more military installations that are under the jurisdiction
of different Secretaries concerned, shall be deemed to refer to
each Secretary concerned who has jurisdiction of such an
installation, acting jointly.
SEC. 3. PILOT PROGRAM ON NURSE HOME VISITS TO REDUCE CHILD ABUSE AND
IMPROVE SAFE CHILDCARE AMONG MILITARY FAMILIES.
(a) Pilot Program Required.--
(1) In general.--The Secretary of Defense shall, acting
through the Defense Health Agency, carry out a pilot program on
universal nurse home visits designed to provide eligible
covered beneficiaries and their families training on safe
childcare practices aimed at reducing child abuse and
fatalities due to abuse and neglect, assessments of risk
factors for child abuse, and connections with community
resources to meet identified needs.
(2) Scope.--The pilot program shall be designed to
facilitate connections between covered beneficiaries and their
families and community services and resources (including
services and resources provided by the Department of Defense),
and shall not be designed to replace any other resources
currently available to covered beneficiaries and their
families. The pilot program, including the practices covered by
training pursuant to the pilot program, shall conform to
evidence-based scientific criteria, including criteria
available through publications in peer-reviewed scientific
journals.
(3) Discharge.--The pilot program shall be carried out
through a contract with an entity selected by the Secretary for
purposes of the pilot program from among entities capable of
meeting the requirements of the pilot program, including the
provision of training for nurses who makes visits under the
pilot program on evidence-based practices in connection
universal nurse home visits.
(b) Locations.--The pilot program required by this section shall be
carried out at military installations selected by the Secretary for
purposes of the pilot program as follows:
(1) Not fewer than five installations that are locations of
a military medical treatment facility.
(2) Such other installations as the Secretary considers
appropriate from among installations representing a range of
situations, including installations in an urban location and a
rural location, installations with a large population and with
a small population, installations currently experiencing high
incidence of child abuse, neglect, or both and low incidence of
child abuse, neglect, or both, installations within the United
States and outside the United States, joint installations, and
installations serving only one Armed Force.
(c) Elements.--The pilot program shall include the following:
(1) Between one and three home visits described in
subsection (f), and not more than seven other contacts, except
in unusual cases (such as deployments), with such home visits
by a team led by a licensed nurse to provide screening,
community resource referral, and training to eligible covered
beneficiaries participating in the pilot program and their
families on the following:
(A) General maternal and infant health.
(B) Safe sleeping environments.
(C) Feeding and bathing.
(D) Adequate supervision.
(E) Common hazards.
(F) Self-care.
(G) Recognition of post-partum depression,
substance abuse, domestic violence in a mother or her
partner, and community violence.
(H) Skills for management of infant crying.
(I) Other positive parenting skills and practices.
(J) The importance of participating in ongoing
healthcare for an infant and in ongoing healthcare for
post-partum depression.
(K) Finding, qualifying for, and participating in
available community resources with respect to infant
care, childcare, and parenting support.
(L) Planning for parenting, co-parenting, or
guardianship of children during deployment.
(M) Such other matters as the Secretary considers
appropriate.
(2) Services and resources on offer or as otherwise
available as described in subsection (g).
(3) An electronic integrated data system as described in
subsection (h) relating to--
(A) availability and use of services and resources
under the pilot program;
(B) tracking of interactions between teams
described in paragraph (1) and eligible beneficiaries
and their families under the pilot program; and
(C) evaluation of the effectiveness of the pilot
program.
(d) Medical Staff.--The Secretary shall ensure that the pilot
program is carried out by licensed medical staff of the Department,
such as obstetrics or pediatric nursing staff, and not family advocacy
staff.
(e) Mandatory Participation.--
(1) In general.--Except as provided in paragraph (2), the
Secretary shall require all eligible covered beneficiaries at
military installations at which the pilot program is carried
out to be contacted as described in subsection (c)(1).
(2) Exception.--The Secretary shall encourage participation
by both parents of a child in the pilot program, but
participation by one parent shall be sufficient to meet the
requirement under paragraph (1).
(f) Home Visits.--
(1) In general.--The home visits described in subsection
(c)(1) shall include the following:
(A) An initial contact made prenatally (except when
not possible, in which case the contact shall occur in
the hospital or birthing location as soon after birth
as possible) by a team described in subsection (c)(1),
which shall include screening for the matters specified
in that subsection.
(B) If a parent is deployed at the time of birth--
(i) the first home visit pursuant to
subparagraph (A) shall, to the extent
practicable, incorporate both parents, in
person with the local parent and by electronic
means (such as Skype or FaceTime) with the
deployed parent; and
(ii) another such home visit shall be
conducted at a reasonable time after the return
of the parent from deployment (in order to
allow for reintegration), and shall include
both parents.
(C) Home visits by a nurse trained in the practices
covered by the pilot program at the birth of a child,
which visits shall follow a research-based structured
clinical protocol.
(2) Timing of visits.--The home first visit under paragraph
(1) shall occur between two and five weeks after discharge from
hospital or birthing plan, with appropriate follow-up generally
accomplished within 2 home visits.
(3) Duration of visits.--Visits under this subsection shall
have a duration between 90 minutes and 2 hours.
(4) Final visit.--Not later than 45 days after the last
visit conducted by a nurse under paragraph (1) with respect to
an eligible covered beneficiary, appropriate staff shall
follow-up with the beneficiary and the beneficiary's family to
assess if they are using the services available as described in
subsection (g).
(g) Services and Resources.--
(1) In general.--In carrying out the pilot program under
this section, the Secretary shall--
(A) offer applicable available services and
resources of the Department to eligible covered
beneficiaries participating in the pilot program and
their families based on the particular needs of the
beneficiaries and their families; and
(B) inform beneficiaries and their families of
applicable services and resources that are otherwise
available in the community concerned in connection with
the pilot program.
(2) Voluntary participation.--Participation by an eligible
covered beneficiary and family in any service or resource
offered or available under paragraph (1) shall be at the
election of the beneficiary.
(3) Needs assessments of eligible covered beneficiaries.--
(A) In general.--In offering services and resources
under paragraph (1)(A), the Secretary shall conduct, or
attempt to conduct, an assessment of every eligible
covered beneficiary and beneficiary family
participating in the pilot program, regardless of risk
factors, to determine which services and resources to
offer such beneficiary and family under that paragraph.
(B) Particular needs.--In conducting an assessment
of an eligible covered beneficiary and family under
subparagraph (A), the Secretary shall assess their
needs and eligibility for particular services and
resources and connect the beneficiary and family to
services and resources for which they have a need and
are eligible, either within the Department of Defense
or elsewhere.
(h) Electronic Integrated Data System.--Before commencing the pilot
program, the entity with which the Secretary contracts under subsection
(a)(3) shall develop and deploy an electronic integrated data system,
tailorable to each military installation at which the pilot program is
carried out and created in consultation with experts in community
resources available in the vicinity of such installation, for purposes
of as follows:
(1) To list all services and resources to be offered under
subsection (g)(1)(A) to eligible covered beneficiaries and
their families.
(2) To inform beneficiaries and their families pursuant to
subsection (g)(1)(B) of services and resources that are
otherwise available in the community concerned in connection
with the pilot program.
(3) To track interactions between teams described in
subsection (c)(1) and beneficiaries and their families under
the pilot program.
(4) To track the services and resources used by
beneficiaries and their families under the pilot program in
order to evaluate the implementation and impact of the program.
(5) To otherwise track and assess the effectiveness of the
pilot program.
(i) Two-Year Assessment.--Two years after the commencement of the
pilot program, the Secretary conduct an assessment of the effectiveness
of the pilot program.
(j) Reports.--
(1) Initial report.--Not later than 180 days after the date
of the enactment of this Act, the Secretary shall submit to the
Committees on Armed Services of the Senate and the House of
Representatives a report on the pilot program required by this
section. The report shall include a comprehensive description
of the pilot program, including the following:
(A) The installations at which the pilot program is
being carried out.
(B) The strategy and metrics for evaluating the
effectiveness of the pilot program for purposes of the
report under paragraph (2).
(2) Final report.--Not later than 180 days after the
completion of the pilot program, the Secretary shall submit to
the committees specified in paragraph (1) a report on the pilot
programs. The report shall include the following:
(A) A comprehensive description and assessment of
the pilot program, including an assessment of each of
the following:
(i) The electronic integrated data system
required by subsection (h).
(ii) The ability of nurses to contact
eligible covered beneficiaries and families
eligible for participation in the pilot
program.
(iii) The extent to which families eligible
for participation in the pilot program actually
participate in the pilot program.
(iv) The characteristics of families
eligible for participation in the pilot program
that do not participate in the pilot program,
and summaries of the reasons for lack of
participation.
(v) The ability of nurses to adhere to the
clinical protocols of the pilot program.
(vi) The extent to which families
participating in the program are being
connected to services and resources under the
pilot program.
(vii) The extent to which families
participating in the pilot program are using
services and resources under the pilot program.
(B) Such recommendations for legislative or
administrative action as the Secretary considers
appropriate in light of the pilot program, including
expansion or extension of the pilot program.
(k) Ongoing Evaluation.--
(1) In general.--Not later than three years after the date
of the report required by subsection (j)(2), and every five
years thereafter, the Secretary shall conduct a scientifically
rigorous evaluation of universal nurse home visits provided in
accordance with this section, using administrative records, in
order to assess the effectiveness of such visits in--
(A) reducing incidence of child abuse and neglect
and fatalities due to abuse and neglect; and
(B) reducing emergency health care utilization for
child injuries.
(2) Scope of evaluation.--Each evaluation shall include a
review of available referrals to the Family Advocacy Program,
child hospital administration records, community-wide child
protective service investigations, and such other indicators
and sources of information as the Secretary considers
appropriate.
(l) Implementation Defense-Wide.--If the Secretary determines as a
result of the pilot program that any element of the pilot program is
effective, the Secretary shall take appropriate actions to implement
the pilot program as a program throughout and across the military
installations of the Department.
(m) Definitions.--In this section:
(1) The term ``community'', with respect to a military
installation, means the catchment area for community services
of the installation, including services provided on the
installation and services provided by State, county, and local
jurisdictions in which the installation is located or in the
vicinity of the installation.
(2) The term ``eligible covered beneficiary'' means a
covered beneficiary (as that term is defined in section 1072 of
title 10, United States Code) who has a child under the age of
five years or is expecting a child.
(n) Funding.--
(1) Authorization of appropriations.--There is hereby
authorized to be appropriated for fiscal year 2019 for the
Department of Defense $5,000,000 to carry out the pilot
program.
(2) Availability.--The amount authorized to be appropriated
by paragraph (1) shall remain available until expended.
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