[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4367 Introduced in House (IH)]







109th CONGRESS
  1st Session
                                H. R. 4367

  To improve the health care system's response to domestic violence, 
dating violence, sexual assault, and stalking through the training and 
  education of health care providers, developing comprehensive public 
                     health responses to violence.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 17, 2005

 Mrs. Capps (for herself, Mr. LaTourette, Mr. Waxman, and Mrs. Lowey) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To improve the health care system's response to domestic violence, 
dating violence, sexual assault, and stalking through the training and 
  education of health care providers, developing comprehensive public 
                     health responses to 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, 
Treatment, and Prevention Act''.

SEC. 2. PURPOSE.

    It is the purpose of this Act to improve the health care system's 
response to domestic violence, dating violence, sexual assault, and 
stalking through the training and education of health care providers, 
developing comprehensive public health responses to violence.

SEC. 3. TRAINING AND EDUCATION OF HEALTH PROFESSIONALS IN DOMESTIC AND 
              SEXUAL VIOLENCE.

    Part D of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.) is amended by adding at the end the following:

``SEC. 758. INTERDISCIPLINARY TRAINING AND EDUCATION ON DOMESTIC 
              VIOLENCE AND OTHER TYPES OF VIOLENCE AND ABUSE.

    ``(a) Grants.--The Secretary, acting through the Director of the 
Health Resources and Services Administration, shall award grants under 
this section to develop interdisciplinary training and education 
programs that provide undergraduate, graduate, post-graduate medical, 
nursing (including advanced practice nursing students), and other 
health professions students with an understanding of, and clinical 
skills pertinent to, domestic violence, sexual assault, stalking, and 
dating violence.
    ``(b) Eligibility.--To be eligible to receive a grant under this 
section an entity shall--
            ``(1) be an accredited school of allopathic or osteopathic 
        medicine;
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require, including--
                    ``(A) information to demonstrate that the applicant 
                includes the meaningful participation of a school of 
                nursing and at least one other school of health 
                professions or graduate program in public health, 
                dentistry, social work, midwifery, or behavioral and 
                mental health;
                    ``(B) strategies for the dissemination and sharing 
                of curricula and other educational materials developed 
                under the grant to other interested medical and nursing 
                schools and national resource repositories for 
                materials on domestic violence and sexual assault; and
                    ``(C) a plan for consulting with, and compensating 
                community-based coalitions or individuals who have 
                experience and expertise in issues related to domestic 
                violence, sexual assault, dating violence, and stalking 
                for services provided under the program carried out 
                under the grant.
    ``(c) Use of Funds.--
            ``(1) Required uses.--Amounts provided under a grant under 
        this section shall be used to--
                    ``(A) fund interdisciplinary training and education 
                projects that are designed to train medical, nursing, 
                and other health professions students and residents to 
                identify and provide health care services (including 
                mental or behavioral health care services and referrals 
                to appropriate community services) to individuals who 
                are or who have experienced domestic violence, sexual 
                assault, and stalking or dating violence; and
                    ``(B) plan and develop culturally competent 
                clinical components for integration into approved 
                residency training programs that address health issues 
                related to domestic violence, sexual assault, dating 
                violence, and stalking, along with other forms of 
                violence as appropriate, and include the primacy of 
                victim safety and confidentiality.
            ``(2) Permissive uses.--Amounts provided under a grant 
        under this section may be used to--
                    ``(A) offer community-based training opportunities 
                in rural areas for medical, nursing, and other students 
                and residents on domestic violence, sexual assault, 
                stalking, and dating violence, and other forms of 
                violence and abuse, which may include the use of 
                distance learning networks and other available 
                technologies needed to reach isolated rural areas; or
                    ``(B) provide stipends to students from racial and 
                ethnic population groups who are underrepresented in 
                the health professions as necessary to promote and 
                enable their participation in clerkships, 
                preceptorships, or other offsite training experiences 
                that are designed to develop health care clinical 
                skills related to domestic violence, sexual assault, 
                dating violence, and stalking.
            ``(3) Requirements.--
                    ``(A) Confidentiality and safety.--Grantees under 
                this section shall ensure that all educational programs 
                developed with grant funds address issues of 
                confidentiality and patient safety, and that faculty 
                and staff associated with delivering educational 
                components are fully trained in procedures that will 
                protect the immediate and ongoing security of the 
                patients, patient records, and staff. Advocacy-based 
                coalitions or other expertise available in the 
                community shall be consulted on the development and 
                adequacy of confidentially and security procedures, and 
                shall be fairly compensated by grantees for their 
                services.
                    ``(B) Rural programs.--Rural training programs 
                carried out under paragraph (2)(A) shall reflect 
                adjustments in protocols and procedures or referrals 
                that may be needed to protect the confidentiality and 
                safety of patients who live in small or isolated 
                communities and who are currently or have previously 
                experienced violence or abuse.
            ``(4) Child and elder abuse.--Issues related to child and 
        elder abuse may be addressed as part of a comprehensive 
        programmatic approach implemented under a grant under this 
        section.
    ``(d) Requirements of Grantees.--
            ``(1) Limitation on administrative expenses.--A grantee 
        shall not use more than 10 percent of the amounts received 
        under a grant under this section for administrative expenses.
            ``(2) Contribution of funds.--A grantee under this section, 
        and any entity receiving assistance under the grant for 
        training and education, shall contribute non-Federal funds, 
        either directly or through in-kind contributions, to the costs 
        of the activities to be funded under the grant in an amount 
        that is not less than 25 percent of the total cost of such 
        activities.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $3,000,000 for each of fiscal 
years 2006 through 2010. Amounts appropriated under this subsection 
shall remain available until expended.''.

SEC. 4. GRANTS TO FOSTER PUBLIC HEALTH RESPONSES TO DOMESTIC VIOLENCE, 
              DATING VIOLENCE, SEXUAL ASSAULT, AND STALKING 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. 399P. GRANTS TO FOSTER PUBLIC HEALTH RESPONSES TO DOMESTIC 
              VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND STALKING.

    ``(a) Authority to Award Grants.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall award grants to eligible State, tribal, territorial, or 
        local entities to strengthen the response of State, tribal, 
        territorial, or local health care systems to domestic violence, 
        dating violence, sexual assault, and stalking.
            ``(2) Eligible entities.--To be eligible to receive a grant 
        under this section, an entity shall--
                    ``(A) be--
                            ``(i) a State department (or other 
                        division) of health, a State domestic or sexual 
                        assault coalition or service-based program, or 
                        any other nonprofit, nongovernmental, tribal, 
                        territorial, or State entity with a history of 
                        effective work in the fields of domestic 
                        violence, dating violence, sexual assault or 
                        stalking, and health care; or
                            ``(ii) a nonprofit domestic violence, 
                        dating violence, sexual assault, or stalking 
                        service-based program, a local department (or 
                        other division) of health, a local health 
                        clinic, hospital, or health system, or any 
                        other nonprofit, tribal, or local entity with a 
                        history of effective work in the field of 
                        domestic or sexual violence and health;
                    ``(B) prepare and submit to the Secretary an 
                application at such time, in such manner, and 
                containing such agreements, assurances, and information 
                as the Secretary determines to be necessary to carry 
                out the purposes for which the grant is to be made; and
                    ``(C) demonstrate that the entity is representing a 
                team of organizations and agencies working 
                collaboratively to strengthen the response of the 
                health care system involved to domestic violence, 
                dating violence, sexual assault, or stalking and that 
                such team includes domestic violence, dating violence, 
                sexual assault or stalking and health care 
                organizations.
            ``(3) Duration.--A program conducted under a grant awarded 
        under this section shall not exceed 3 years.
    ``(b) Use of Funds.--
            ``(1) In general.--An entity shall use amounts received 
        under a grant under this section to design and implement 
        comprehensive strategies to improve the response of the health 
        care system involved to domestic or sexual violence in clinical 
        and public health settings, hospitals, clinics, managed care 
        settings (including behavioral and mental health), and other 
        health settings.
            ``(2) Mandatory strategies.--Strategies implemented under 
        paragraph (1) shall include the following:
                    ``(A) The implementation, dissemination, and 
                evaluation of policies and procedures to guide health 
                care professionals and behavioral and public health 
                staff in responding to domestic violence, dating 
                violence, sexual assault, and stalking, including 
                strategies to ensure that health information is 
                maintained in a manner that protects the patient's 
                privacy and safety and prohibits insurance 
                discrimination.
                    ``(B) 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 
                behavioral and public health staff to address domestic 
                violence, dating violence, sexual assault, and 
                stalking, by contracting with or hiring domestic or 
                sexual assault advocates to provide the services, or to 
                model other services appropriate to the geographic and 
                cultural needs of a site.
                    ``(C) The development or adaptation and 
                dissemination of education materials for patients and 
                health care professionals and behavioral and public 
                health staff.
                    ``(D) The evaluation of practice and the 
                institutionalization of identification, intervention, 
                and documentation including quality improvement 
                measurements.
            ``(3) Permissive strategies.--Strategies implemented under 
        paragraph (1) may include the following:
                    ``(A) Where appropriate, the development of 
                training modules and policies that address the overlap 
                of child abuse, domestic violence, dating violence, 
                sexual assault, and stalking and elder abuse as well as 
                childhood exposure to domestic violence.
                    ``(B) The creation, adaptation, and implementation 
                of public education campaigns for patients concerning 
                domestic violence, dating violence, sexual assault, and 
                stalking prevention.
                    ``(C) The development, adaptation, and 
                dissemination of domestic violence, dating violence, 
                sexual assault, and stalking education materials to 
                patients and health care professionals and behavioral 
                and public health staff.
                    ``(D) The promotion of the inclusion of domestic 
                violence, dating violence, sexual assault, and stalking 
                into health professional training schools, including 
                medical, dental, nursing school, social work, and 
                mental health curriculum.
                    ``(E) The integration of domestic violence, dating 
                violence, sexual assault, and stalking into health care 
                accreditation and professional licensing examinations, 
                such as medical, dental, social work, and nursing 
                boards.
    ``(c) Allocation of Funds.--Funds appropriated under this section 
shall be distributed equally between State and local programs.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to award grants under this section, $5,000,000 for each of 
fiscal years 2006 through 2010.''.

SEC. 5. IMPROVING FEDERAL HEALTH PROGRAMS' RESPONSE TO DOMESTIC 
              VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND STALKING.

    (a) Training Grants Under the Maternal and Child Health Services 
Block Grant.--
            (1) Preference in certain funding.--Section 502(b)(2) of 
        the Social Security Act (42 U.S.C. 702(b)(2)) is amended by 
        adding at the end the following:
    ``(C) Of the amounts retained for projects described in 
subparagraphs (A) through (F) of section 501(a)(3), the Secretary shall 
provide preference to qualified applicants that demonstrate that the 
activities to be carried out with such amounts include training of 
service providers in how to identify and treat the health effects of 
domestic violence, dating violence, sexual assault, or stalking, 
including children who have been exposed to domestic or dating 
violence. Such training should include--
            ``(i) identifying patients of clients experiencing domestic 
        violence, dating violence sexual assault, or stalking;
            ``(ii) assessing the immediate and short-term safety of the 
        patient or client, the impact of the abuse on the health of the 
        patient, and assisting the patient in developing a plan to 
        promote his or her safety;
            ``(iii) examining and treating such patients or clients 
        within the scope of the health professional's discipline, 
        training, and practice (including providing medical advice 
        regarding the dynamics and nature of domestic violence, dating 
        violence sexual assault, or stalking);
            ``(iv) maintaining complete medical or forensic records 
        that include the documentation of the examination, treatment 
        given, and referrals made, and recording the location and 
        nature of the victim's injuries, and establishing mechanisms to 
        ensure the privacy and confidentiality of those medical 
        records;
            ``(v) referring the patient or client to public and private 
        nonprofit entities that provide services for such victims; and
            ``(vi) ensuring that all services are provided in a 
        linguistically and culturally relevant manner.''.
            (2) Requirement for portion of expenditures on domestic 
        violence identification and treatment.--Section 505(a)(5) of 
        the Social Security Act (42 U.S.C. 705(a)(5)) is amended--
                    (A) in subparagraph (E), by striking ``and'' at the 
                end;
                    (B) in subparagraph (F), by striking the period and 
                inserting ``; and''; and
                    (C) by inserting after subparagraph (F), the 
                following:
                    ``(G) the State will set aside a reasonable portion 
                (based upon the State's previous use of funds under 
                this title) of the funds provided for domestic 
                violence, dating violence, sexual assault, or stalking 
                services.''.
            (3) Reporting data.--Section 506(a)(2) of the Social 
        Security Act (42 U.S.C. 706(a)(2)) is amended by inserting 
        after subparagraph (E) the following:
            ``(F) Information on how funds provided under this title 
        are used to identify and treat domestic violence, dating 
        violence, sexual assault, or stalking.''.
            (4) Separate program for domestic violence, dating 
        violence, sexual assault, and stalking identification and 
        treatment.--Title V of the Social Security Act (42 U.S.C. 701 
        et seq.) is amended by adding at the end the following:

``SEC. 511. SEPARATE PROGRAM FOR DOMESTIC VIOLENCE, DATING VIOLENCE, 
              SEXUAL ASSAULT AND STALKING SCREENING AND TREATMENTS.

    ``(a) Allotments.--For the purpose described in subsection (b), the 
Secretary shall, for fiscal year 2006 and each subsequent fiscal year, 
allot to each State that has transmitted an application for the fiscal 
year under section 505(a) an amount equal to the product of--
            ``(1) the amount appropriated under subsection (d) for the 
        fiscal year; and
            ``(2) the percentage determined for the State under section 
        502(c)(1)(B)(ii).
    ``(b) Purpose.--The purpose of an allotment under subsection (a) 
with respect to a State is to enable the State to provide for domestic 
violence, dating violence, sexual assault, or stalking identification 
and treatment, including the provision of domestic violence, dating 
violence, sexual assault, or stalking identification, treatment 
services, increasing the number of persons identified, assessed, 
treated, and referred, and including training of health care 
professionals, and behavioral and public health staff, on how to 
identify and respond to adult and minor patients experiencing domestic 
violence, dating violence, sexual assault, or stalking. Such training 
shall include--
            ``(1) identifying patients of clients experiencing domestic 
        violence, dating violence sexual assault, or stalking;
            ``(2) assessing the immediate and short-term safety of the 
        patient or client, the impact of the abuse on the health of the 
        patient, and assisting the patient in developing a plan to 
        promote his or her safety;
            ``(3) examining and treating such patients or clients 
        within the scope of the health professional's discipline, 
        training, and practice (including providing medical advice 
        regarding the dynamics and nature of domestic violence, dating 
        violence sexual assault, or stalking);
            ``(4) maintaining complete medical or forensic records that 
        include the documentation of the examination, treatment given, 
        and referrals made, and recording the location and nature of 
        the victim's injuries, and establishing mechanisms to ensure 
        the privacy and confidentiality of those medical records;
            ``(5) referring the patient or client to public and private 
        nonprofit entities that provide services for such victims; and
            ``(6) ensuring that all services are provided in a 
        linguistically and culturally relevant manner.
    ``(c) Application of Provisions.--
            ``(1) In general.--Sections 503, 507, and 508 apply to 
        allotments under subsection (a) to the same extent and in the 
        same manner as such sections apply to allotments under section 
        502(c).
            ``(2) Secretarial discretion.--Sections 505 and 506 apply 
        to allotments under subsection (a) to the extent determined by 
        the Secretary to be appropriate.
    ``(d) Authorization of Appropriations.--For the purpose of making 
allotments under subsection (a), there are authorized to be 
appropriated $4,000,000 for each of fiscal years 2006 through 2010.''.
    (b) Domestic Violence, Dating Violence, Sexual Assault, and 
Stalking Identification and Treatment Services at Community Health 
Centers.--Part P of title III of the Public Health Service Act (42 
U.S.C. 280g et seq.), as amended by section 5, is further amended by 
adding at the end the following:

``SEC. 399P-1. DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT AND 
              STALKING PREVENTION, IDENTIFICATION, AND TREATMENT 
              GRANTS.

    ``(a) Grants Authorized.--The Secretary is authorized to award 
grants to eligible entities to improve the identification and treatment 
of domestic violence, dating violence, sexual assault, or stalking.
    ``(b) Use of Funds.--Grants awarded under subsection (a) may be 
used for activities such as--
            ``(1) the implementation, dissemination, and evaluation of 
        policies and procedures to guide health care and behavioral 
        health care professionals and other staff responding to 
        domestic violence, dating violence, sexual assault, or 
        stalking;
            ``(2) the provision of training and follow-up technical 
        assistance to health care professionals and staff to identify 
        domestic violence, dating violence, sexual assault, or 
        stalking, and to appropriately assess, treat, and refer 
        patients who are victims of domestic violence, dating violence, 
        sexual assault, or stalking; 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 or sexual 
        assault advocates to provide the services, or by developing 
        other models appropriate to the geographic, cultural, and 
        linguistic needs of a site.
    ``(c) Eligibility.--To be eligible for a grant under this section, 
an entity shall--
            ``(1) be a federally qualified health center as defined in 
        section 1861(aa)(4) of the Social Security Act (42 U.S.C. 
        1395x(aa)(4)); and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and accompanied by such information 
        as the Secretary may require.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $4,000,000 for each of fiscal 
years 2006 through 2010.''.

SEC. 6. RESEARCH ON EFFECTIVE INTERVENTIONS IN THE HEALTHCARE SETTING.

    Subtitle B of the Violence Against Women Act of 1994 (Public Law 
103-322; 108 Stat. 1902 et seq.), as amended by the Violence Against 
Women Act of 2000 (114 Stat. 1491 et seq.), and as amended by this Act, 
is further amended by adding at the end the following:

 ``CHAPTER 11--RESEARCH ON EFFECTIVE INTERVENTIONS TO ADDRESS VIOLENCE 
                             AGAINST WOMEN

``SEC. 40297. RESEARCH ON EFFECTIVE INTERVENTIONS IN THE HEALTH CARE 
              SETTING.

    ``(a) Purpose.--The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention and the Director of the 
Agency for Healthcare Research and Quality, shall award grants and 
contracts to fund research on effective interventions in the health 
care setting that prevent domestic violence, dating violence, and 
sexual assault across the lifespan and that prevent the health effects 
of such violence and improve the safety and health of individuals who 
are currently being victimized.
    ``(b) Use of Funds.--Research conducted with amounts received under 
a grant or contract under this section shall include--
            ``(1) with respect to the authority of the Centers for 
        Disease Control and Prevention--
                    ``(A) research on the effects of domestic violence, 
                dating violence, sexual assault, and childhood exposure 
                to domestic, dating, or sexual violence, on health 
                behaviors, health conditions, and the health status of 
                individuals, families, and populations; and
                    ``(B) research and testing of best messages and 
                strategies to mobilize public action concerning the 
                prevention of domestic, dating, or sexual violence
            ``(2) with respect to the authority of the Agency for 
        Healthcare Research and Quality--
                    ``(A) research on the impact on the health care 
                system, health care utilization, health care costs, and 
                health status of domestic and dating violence and 
                childhood exposure to domestic and dating violence; and
                    ``(B) research on effective interventions within 
                primary care and emergency health care settings and 
                with health care settings that include clinical 
                partnerships within community domestic violence 
                providers for adults and children exposed to domestic 
                or dating violence.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $5,000,000 for each of fiscal 
years 2006 through 2010.''.
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