[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 869 Introduced in Senate (IS)]

103d CONGRESS
  1st Session
                                 S. 869

  To amend the Public Health Service Act to provide for demonstration 
projects for the identification by health care providers of victims of 
 domestic violence and sexual assault, to provide for the education of 
 the public on the consequences to the public health of such violence 
 and assault, to provide for epidemiological research on such violence 
                  and assault, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                May 4 (legislative day, April 19), 1993

 Mr. Wellstone (for himself and Mr. Kennedy) introduced the following 
 bill; which was read twice and referred to the Committee on Labor and 
                            Human Resources

_______________________________________________________________________

                                 A BILL


 
  To amend the Public Health Service Act to provide for demonstration 
projects for the identification by health care providers of victims of 
 domestic violence and sexual assault, to provide for the education of 
 the public on the consequences to the public health of such violence 
 and assault, to provide for epidemiological research on such violence 
                  and assault, 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 ``Violence Reduction Training Act''.

SEC. 2. FINDINGS.

    The Congress finds the following:
            (1) Domestic violence and sexual assault represent serious 
        threats to the health and well-being of millions of women in 
        the United States.
            (2) Violence against women has serious health consequences 
        for its victims, including fatality, severe trauma, repeated 
        physical injuries, and chronic stress-related disorder.
            (3) Violence against women has serious mental health 
        consequences for its victims, including substance abuse, severe 
        psychological trauma, and suicide.
            (4) Approximately 4,000,000 women in the United States are 
        victims of domestic violence each year.
            (5) One of two women is a victim of domestic violence or 
        sexual assault during her lifetime.
            (6) Battering is the leading cause of injury to women.
            (7) It has been estimated that 1 in 6 pregnant women are 
        battered, resulting in increased rates of miscarriage, 
        stillbirths, and low-birthweight babies.
            (8) Domestic violence may account for as much as one-third 
        of emergency-room visits by women, an annual total of 
        approximately 28,700 such visits.
            (9) Estimates based on the National Crime Survey provide 
        that domestic violence accounts for 21,000 hospitalizations, 
        99,800 days of hospitalization, and 39,900 visits to a 
        physician each year.
            (10) Fewer than 5 percent of injured women are correctly 
        diagnosed by medical personnel as being victims of domestic 
        violence.
            (11) Hospitals and clinics do not have a uniform set of 
        protocols for the identification and referral of victims of 
        domestic violence and sexual assault, or for the training of 
        health care professionals to perform such functions.
            (12) A national surveillance system for monitoring the 
        health effects of domestic violence and sexual assault should 
        be established to determine the nature and extent of such 
        violence and assault in the United States.
            (13) The Surgeon General has identified domestic violence 
        as a public health problem to which all health care providers 
        must actively and vigorously respond.
            (14) Estimates of the percentage of male batterers who also 
        abuse their children range from 50 percent to 75 percent.

SEC. 3. ESTABLISHMENT OF CERTAIN HEALTH PROGRAMS REGARDING DOMESTIC 
              VIOLENCE AND SEXUAL ASSAULT.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.), as amended by section 308 of Public Law 102-531 (106 Stat. 
3495), is amended by inserting after section 317D the following 
section:

    ``health programs regarding domestic violence and sexual assault

    ``Sec. 317E. (a) Demonstration Projects for Identification and 
Referrals of Victims.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, may 
        award grants, contracts and cooperative agreements to public 
        and nonprofit private entities for the purpose of carrying out 
        demonstration projects in which health care providers are 
        trained to--
                    ``(A) appropriately interview and identify 
                individuals whose medical condition or statements 
                indicate that the individuals are victims of domestic 
                violence or sexual assault; and
                    ``(B) refer the individuals to entities that 
                provide services regarding such violence and assault, 
                including referrals for counseling, housing (including 
                temporary housing), legal services, and services of 
                community organizations.
            ``(2) Application.--A grant, contract or cooperative 
        agreement may not be made or entered into under this section 
        unless an application for such grant, contract or agreement has 
        been submitted to and approved by the Secretary.
            ``(3) Approval.--A grant, contract or cooperative agreement 
        under this section shall be awarded in accordance with such 
        regulations as the Secretary may promulgate. To be approved by 
        the Secretary, an application submitted under paragraph (2) 
        shall--
                    ``(A) demonstrate that the applicant intends to use 
                protocols developed by or under development by entities 
                with demonstrated expertise in domestic violence or 
                sexual assault; and
                    ``(B) demonstrate that, in providing such training, 
                the applicant is willing to work with local groups that 
                have expertise in treatment and prevention of domestic 
                violence and sexual assault.
            ``(4) Considerations.--In awarding a grant, contract or 
        cooperative agreement under this section, the Secretary shall 
        take into account--
                    ``(A) the number of health care providers to be 
                trained;
                    ``(B) the diversity of health care providers to be 
                trained; and
                    ``(C) the extent to which a hospital is actively 
                complying with the standards of the Joint Commission on 
                Accreditation of Hospitals and Organizations to promote 
                improved recognition and treatment of possible victims 
                of abuse in hospitals, emergency departments, and 
                ambulatory care units, when training hospital-based 
                health care providers.
            ``(5) Reports.--The Secretary may award a grant, contract 
        or cooperative agreement under paragraph (1) only if the 
        applicant for the grant, contract or cooperative agreement 
        agrees to submit to the Secretary a report describing the 
        activities of the project under such paragraph for the fiscal 
        year for which the grant, contract or cooperative agreement is 
        awarded.
    ``(b) Public Education.--The Secretary, acting through the Director 
of the Centers for Disease Control and Prevention, shall carry out a 
program to educate health care providers and the public on the 
consequences to the public health of domestic violence and sexual 
assault.
    ``(c) Epidemiological Research.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall provide for the conduct of epidemiological research on 
        domestic violence and sexual assault. In providing for such 
        research, the Secretary shall ensure that, with respect to such 
        violence and assault, data is collected on--
                    ``(A) the incidence of cases and the effect of the 
                cases on the costs of health care in the United States;
                    ``(B) the type and severity of injuries sustained 
                and the type and severity of any other resulting health 
                conditions;
                    ``(C) the extent to which victims seek treatment, 
                including a comparison of the incidence of cases with 
                the incidence of seeking treatment;
                    ``(D) a description of common circumstances 
                influencing victims not to seek treatment;
                    ``(E) the types of medical facilities and health 
                care providers from which victims seek treatment; and
                    ``(F) the demographic characteristics of the 
                individuals from whom data described in subparagraphs 
                (A) through (E) is collected.
            ``(2) National system.--In carrying out paragraph (1), the 
        Secretary shall cooperate with the States for the purpose of 
        establishing, to the extent practicable, a national system for 
        the collection of data regarding domestic violence and sexual 
        assault.
            ``(3) Confidentiality.--Standards of confidentiality under 
        section 308(d) shall apply to data collected under paragraph 
        (1) to the same extent and in the same manner as such section 
        applies to information obtained under section 304, 306, or 307.
            ``(4) Report.--Not later than February 1, 1996, and every 2 
        years thereafter, the Secretary shall submit to the Congress a 
        report summarizing the data collected under paragraph (1) for 
        the preceding 2 years.
    ``(c) Authorization of Appropriations.--
            ``(1) In general.--For the purpose of carrying out this 
        section, there are authorized to be appropriated $20,000,000 
        for fiscal year 1994, and such sums as may be necessary for 
        each of the fiscal years 1995 through 1997.
            ``(2) Allocation for demonstration projects.--Of the 
        amounts appropriated under paragraph (1) for a fiscal year, the 
        Secretary shall make available not less than 60 percent for 
        grants, contracts or cooperative agreements under subsection 
        (a).''.

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