[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 2236 Introduced in Senate (IS)]







107th CONGRESS
  2d Session
                                S. 2236

To amend title III of the Public Health Service Act to provide coverage 
    for domestic violence screening and treatment, to authorize the 
 Secretary of Health and Human Services to make grants to improve the 
response of health care systems to domestic violence, and train health 
    care providers and federally qualified health centers regarding 
  screening, identification, and treatment for families experiencing 
                           domestic violence.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 24, 2002

 Mr. Wellstone introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend title III of the Public Health Service Act to provide coverage 
    for domestic violence screening and treatment, to authorize the 
 Secretary of Health and Human Services to make grants to improve the 
response of health care systems to domestic violence, and train health 
    care providers and federally qualified health centers regarding 
  screening, identification, and treatment for families experiencing 
                           domestic violence.

    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 ``Domestic Violence Screening and 
Services Act of 2002''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Nearly \1/3\ of American women (31 percent) report 
        being physically or sexually abused by a husband or boyfriend 
        at some point in their lives, and about 1200 women are murdered 
        every year by their intimate partner, nearly 3 each day.
            (2) 85 percent of violent victimizations are experienced by 
        women.
            (3) 37 percent of all women who sought care in hospital 
        emergency rooms for violence-related injuries were injured by a 
        current or former spouse, boyfriend, or girlfriend.
            (4) In addition to injuries sustained during violent 
        episodes, physical and psychological abuse are linked to a 
        number of adverse physical health effects including arthritis, 
        chronic neck or back pain, migraine and other frequent 
        headaches, stammering, problems with vision, and sexually 
        transmitted infections, including HIV/AIDS.
            (5) Medical services for abused women cost an estimated 
        $857,300,000 every year.
            (6) Each year, at least 6 percent of all pregnant women, 
        about 240,000 pregnant women, in this country are battered by 
        the men in their lives. This battering leads to complications 
        of pregnancy, including low weight gain, anemia, infections, 
        and first and second trimester bleeding.
            (7) Pregnant and recently pregnant women are more likely to 
        be victims of homicide than to die of any other cause, and 
        evidence exists that a significant proportion of all female 
        homicide victims are killed by their intimate partners.
            (8) Children who witness domestic violence are more likely 
        to exhibit behavioral and physical health problems including 
        depression, anxiety, and violence towards peers. They are also 
        more likely to attempt suicide, abuse drugs and alcohol, run 
        away from home, engage in teenage prostitution, and commit 
        sexual assault crimes.
            (9) Fifty percent of men who frequently assault their wives 
        frequently assault their children. The United States Advisory 
        Board on Child Abuse and Neglect suggests that domestic 
        violence may be the single major precursor to child abuse and 
        neglect fatalities in this country.
            (10) Currently, about 10 percent of primary care physicians 
        routinely screen for intimate partner abuse during new patient 
        visits and nine percent routinely screen during periodic 
        checkups.
            (11) Recent clinical studies have proven the effectiveness 
        of a 2-minute screening for early detection of abuse of 
        pregnant women. Additional longitudinal studies have tested a 
        10-minute intervention that was proven highly effective in 
        increasing the safety of pregnant abused women. Comparable 
        research does not yet exist to support the effectiveness of 
        screening men.
            (12) 70 to 81 percent of the patients studied reported that 
        they would like their health care providers to ask them 
        privately about intimate partner violence.

SEC. 3. DOMESTIC VIOLENCE PREVENTION GRANTS.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following:

``SEC. 399O. DOMESTIC VIOLENCE PREVENTION GRANTS.

    ``(a) Grants Authorized.--The Secretary is authorized to award 
grants to eligible entities to improve the treatment of and screening 
for domestic violence.
    ``(b) Use of Funds.--Grants awarded pursuant to subsection (a) may 
be used for activities such as--
            ``(1) the implementation, dissemination, and evaluation of 
        policies and procedures to guide health care professionals and 
        staff responding to domestic violence;
            ``(2) the provision of training and follow-up technical 
        assistance to health care professionals and staff to screen for 
        domestic violence, and then to appropriately assess, treat, and 
        refer patients who are victims of domestic violence to domestic 
        violence service providers; and
            ``(3) the development of on-site access to services to 
        address the safety, medical, mental health, and economic needs 
        of patients either by increasing the capacity of existing 
        health care professionals and staff to address these issues or 
        by contracting with or hiring domestic violence advocates to 
        provide the services or other model appropriate to the 
        geographic and cultural needs of a site.
    ``(c) Eligible Entity.--In this section, the term `eligible entity' 
shall means a Federally qualified health centers as defined in section 
1861(aa)(4) of the Social Security Act (42 U.S.C. 1395x(aa)(4)).
    ``(d) Applications.--Each eligible entity desiring a grant under 
this section shall submit an application to the Secretary at such time, 
in such manner, and accompanied by such information as the Secretary 
may require.
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $5,000,000 for each of fiscal years 
        2003, 2004, 2005, and 2006.
            ``(2) Set aside for tribal organizations.--An amount equal 
        to 4 percent of the amount appropriated for a fiscal year in 
        accordance with paragraph (1) to carry out this section shall 
        be set aside for making grants to Indian tribes and tribal 
        organizations (as defined in section 4 of the Indian Self-
        Determination and Education Assistance Act (25 U.S.C. 
        450b)).''.

SEC. 4. NATIONAL HEALTH SERVICE CORPS.

    Section 331 of the Public Health Service Act (42 U.S.C. 254d) is 
amended--
            (1) by redesignating subsection (i) as subsection (j); and
            (2) by inserting after subsection (h) the following:
    ``(i) The Secretary shall ensure that health care professionals 
working in the National Health Service Corps receive training on how to 
screen for domestic violence, and to appropriately assess, treat, and 
refer patients who are victims of domestic violence to domestic 
violence service providers.''.

SEC. 5. GRANTS FOR DOMESTIC VIOLENCE SCREENING AND TREATMENT.

    (a) Authority To Award Grants.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary''), acting 
        through the Assistant Secretary for the Administration for 
        Children and Families, shall award grants under this section to 
        eligible State entities and eligible local entities in order to 
        strengthen the response of State and local health care systems 
        to domestic violence by building the capacity of health care 
        professionals and staff to identify, address, and prevent 
        domestic violence.
            (2) Definitions of eligible entities.--In this section:
                    (A) Eligible state entity.--The term ``eligible 
                State entity'' means a State department (or other 
                division) of health, a nonprofit State domestic 
                violence coalition or service-based program, or any 
                other nonprofit or State entity with a history of 
                effective work in the field of domestic violence and 
                health care, that demonstrates that the applicant is 
                representing a team of organizations and agencies 
                working collaboratively to strengthen the response of 
                the health care system to domestic violence and that 
                such team includes domestic violence and health care 
                organizations.
                    (B) Eligible local entity.--The term ``eligible 
                local entity'' means a nonprofit domestic violence 
                service based program, a local department (or other 
                division) of health, a local health clinic, hospital, 
                or system, or any other nonprofit or local entity with 
                a history of effective work in the field of domestic 
                violence and health care.
    (b) Number and Duration of Programs; Maximum Amount of Grants.--
            (1) Number of programs.--Not more than--
                    (A) 10 programs shall be conducted by eligible 
                State entities under a grant made under this section; 
                or
                    (B) 10 programs shall be conducted by eligible 
                local entities under a grant made under this section.
            (2) Duration.--A program conducted under a grant made under 
        this section by an eligible State entity or an eligible local 
        entity shall not exceed 4 years.
            (3) Maximum amount of grants.--A grant awarded under this 
        section shall not exceed--
                    (A) $350,000 per year, in the case of a program 
                conducted by an eligible State entity; or
                    (B) $150,000 per year, in the case of a program 
                conducted by an eligible local entity.
    (c) Use of Funds.--
            (1) Eligible state entities.--An eligible State entity 
        awarded a grant under this section shall use funds provided 
        under the grant to design and implement comprehensive statewide 
        strategies to improve the response of the health care system to 
        domestic violence in clinical and public health care settings 
        and to promote education and awareness about domestic violence 
        at a statewide level. Such strategies shall include the 
        following:
                    (A) Collaboration with State professional health 
                associations and departments (or other divisions) of 
                health to integrate responses to domestic violence into 
                existing policy, practice, and education efforts.
                    (B) Promotion of policies and funding sources that 
                advance domestic violence screening, training, and 
                protocol development and that protect the 
                confidentiality of patients and prohibit insurance 
                discrimination.
                    (C) Dissemination, implementation, and evaluation 
                of practice guidelines on domestic violence that guide 
                health care providers and public health professionals 
                response to domestic violence.
                    (D) Training and follow-up technical assistance to 
                health care professionals and staff to screen for 
                domestic violence, and then to appropriately assess, 
                treat, and refer patients who are victims of domestic 
                violence to domestic violence services.
                    (E) Creation and implementation of public education 
                campaigns for patients and providers about domestic 
                violence prevention.
                    (F) Development and dissemination of patient and 
                provider education materials.
                    (G) Promotion of the inclusion of domestic violence 
                into medical and nursing school curriculum and 
                integration of domestic violence into health care 
                accreditation and professional licensing examinations, 
                such as medical boards.
                    (H) Evaluation of the practice and 
                institutionalization of screening, intervention, and 
                documentation of domestic violence and promotion of the 
use of quality improvement measurements.
            (2) Eligible local entities.--An eligible local entity 
        awarded a grant under this section shall use funds provided 
        under the grant to design and implement comprehensive local 
        strategies to improve the response of the health care system to 
        domestic violence in hospitals, clinics, managed care settings, 
        emergency medical services, and other health care settings. 
        Such strategies shall include the following:
                    (A) Implementation, dissemination, and evaluation 
                of policies and procedures to guide clinical and public 
                health professionals and staff responding to domestic 
                violence including identification, treatment, and 
                documentation of domestic violence and strategies to 
                ensure that health information is held in a manner that 
                protects the patient's privacy and safety.
                    (B) Training and follow-up technical assistance to 
                health care professionals and staff to screen for 
                domestic violence, and then to appropriately assess, 
                treat, and refer patients who are victims of domestic 
                violence to domestic violence services.
                    (C) Development of on-site access to services to 
                address the safety, medical, mental health, and 
                economic needs of patients either by increasing the 
                capacity of existing health care professionals and 
                staff to address these issues or by contracting with or 
                hiring domestic violence advocates to provide the 
                services, or to model other services appropriate to the 
                geographic and cultural needs of a site.
                    (D) Development or adaptation and dissemination of 
                patient and provider education materials.
                    (E) Evaluation of practice and the 
                institutionalization of screening, intervention, and 
                documentation including quality improvement 
                measurements such as patient satisfaction surveys, 
                patient record reviews, case consultation, or other 
                methods used to evaluate and enhance staff compliance 
                with protocols.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Health and Human Services for the 
purpose of awarding grants under this section, $5,000,000 for each of 
fiscal years 2003 through 2006.
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