[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6083 Introduced in House (IH)]







109th CONGRESS
  2d Session
                                H. R. 6083

To reduce the spread of sexually transmitted infections in correctional 
                  facilities, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 14, 2006

 Ms. Lee (for herself, Mrs. Christensen, Mr. Jackson of Illinois, Ms. 
   Waters, and Mr. Waxman) introduced the following bill; which was 
               referred to the Committee on the Judiciary

_______________________________________________________________________

                                 A BILL


 
To reduce the spread of sexually transmitted infections in correctional 
                  facilities, 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 ``Justice for the Unprotected Against 
Sexually Transmitted Infections among the Confined and Exposed Act of 
2006'' or the ``JUSTICE Act of 2006''.

SEC. 2. FINDINGS.

    The Congress makes the following findings:
            (1) According to the Bureau of Justice Statistics (BJS), 
        2,186,230 persons were incarcerated in the United States as of 
        midyear 2005. Between 1995 and midyear 2005, the number of 
        persons incarcerated in Federal or State correctional 
        facilities increased by an average of 3.4 percent per year. One 
        in every 136 United States residents was incarcerated in a 
        Federal, State, or local correctional facility as of midyear 
        2005.
            (2) As of 2001, 64 percent of incarcerated persons were 
        racial or ethnic minorities. Based on current incarceration 
        rates, BJS estimates that 32 percent of African-American males 
        will enter State or Federal correctional facilities during 
        their lifetime, compared with 17 percent of Hispanic males and 
        5.9 percent of White males.
            (3) There is a disproportionately high rate of HIV/AIDS 
        among incarcerated persons, especially among minorities. 
        Approximately 25 percent of the HIV-positive population of the 
        United States passes through correctional facilities each year. 
        BJS determined that the rate of confirmed AIDS cases is 3 times 
        higher among incarcerated persons than in the general 
        population. Minorities account for the majority of AIDS-related 
        deaths among incarcerated persons, with African-American 
        incarcerated persons 3.5 times more likely than White 
        incarcerated persons and 2.5 times more likely than Hispanic 
        incarcerated persons to die from AIDS-related causes.
            (4) Studies suggest that other sexually transmitted 
        infections (STIs), such as gonorrhea, chlamydia, syphilis, 
        genital herpes, viral hepatitis, and human papillomavirus, also 
        exist at a higher rate among incarcerated persons than in the 
        general population. For instance, researchers have estimated 
        that the rate of Hepatitis C (HCV) infection among incarcerated 
        persons is somewhere between 8 and 20 times higher than that of 
        the general population.
            (5) Correctional facilities lack a uniform system of STI 
        testing and reporting. Establishing a uniform data collection 
        system would assist in developing and targeting counseling and 
        treatment programs for incarcerated persons. Better developed 
        and targeted programs may reduce the spread of STIs.
            (6) Although Congress has acted to reduce the spread of 
        sexual violence in correctional facilities by enacting the 
        National Prison Rape Elimination Act (PREA) of 2003, BJS 
        reported 8,210 allegations of sexual violence in correctional 
        facilities in 2004.
            (7) Approximately 95 percent of all incarcerated persons 
        eventually return to society. According to one study, every 
        year approximately 100,000 persons infected with both HIV and 
        HCV are released from correctional facilities. These 
        individuals comprise approximately 50 percent of all persons 
        with both infections in the United States.
            (8) According to the Centers for Disease Control and 
        Prevention (CDC), latex condoms, when used consistently and 
        correctly, are highly effective in preventing the transmission 
        of HIV. Latex condoms also reduce the risk of other STIs. 
        Despite the effectiveness of condoms in reducing the spread of 
        STIs, the Bureau of Prisons does not recommend their use in 
        correctional facilities.
            (9) The distribution of condoms in correctional facilities 
        is currently legal in certain parts of the United States and 
        the world. The States of Vermont and Mississippi and the 
        District of Columbia allow condom distribution programs in 
        their correctional facilities. The cities of New York, San 
        Francisco, Los Angeles, and Philadelphia also allow condom 
        distribution in their correctional facilities. However, these 
        States and cities operate fewer than 1 percent of all 
        correctional facilities. In one study, researchers found that 
        18 of 31 countries surveyed allowed condom distribution in 
        correctional facilities.
            (10) In 2000 and 2001, researchers surveyed 300 
        incarcerated persons and 100 correctional officers at the 
        Central Detention Facility, a correctional facility operated by 
        the District of Columbia at which condoms are available. 
        Researchers found that both incarcerated persons and 
        correctional officers generally supported the condom 
        distribution program and considered it to be important. 
        Furthermore, the researchers determined that the program had 
        not caused any major security infractions. In Canada, the 
        Expert Committee on AIDS and Prisons surveyed more than 400 
        correctional officers in the Federal prison system of Canada in 
        1995 and reported that 82 percent of those responding indicated 
        that the availability of condoms had created no problems at 
        their facility.
            (11) The American Public Health Association, the United 
        Nations Joint Program on HIV/AIDS, and the World Health 
        Organization have endorsed the effectiveness of condom 
        distribution programs in correctional facilities.
            (12) Many correctional facilities in the United States do 
        not provide comprehensive testing and treatment programs to 
        reduce the spread of STIs. According to BJS surveys from 2000, 
        only 899 of the 1,668 Federal and State correctional facilities 
        (i.e. 54 percent) provided HIV/AIDS counseling programs. Only 
        1,104 of the 1,584 State correctional facilities (i.e. 70 
        percent) reported having a policy of treating incarcerated 
        persons for HCV.

SEC. 3. AUTHORITY TO ALLOW COMMUNITY ORGANIZATIONS TO PROVIDE STI 
              COUNSELING, STI PREVENTION EDUCATION, AND SEXUAL BARRIER 
              PROTECTION DEVICES IN FEDERAL CORRECTIONAL FACILITIES.

    (a) Directive to Attorney General.--Not later than 30 days after 
the date of enactment of this Act, the Attorney General shall direct 
the Bureau of Prisons to allow community organizations to distribute 
sexual barrier protection devices and to engage in STI counseling and 
STI prevention education in Federal correctional facilities. These 
activities shall be subject to all relevant Federal laws and 
regulations which govern visitation in correctional facilities.
    (b) Information Requirement.--Any community organization permitted 
to distribute sexual barrier protection devices under subsection (a) 
must ensure that the persons to whom the devices are distributed are 
informed about the proper use and disposal of sexual barrier protection 
devices in accordance with established public health practices. Any 
community organization conducting STI counseling or STI prevention 
education under subsection (a) must offer comprehensive sexuality 
education.
    (c) Possession of Device Protected.--No Federal correctional 
facility may, because of the possession or use of a sexual barrier 
protection device--
            (1) take adverse action against an incarcerated person; or
            (2) consider possession or use as evidence of prohibited 
        activity for the purpose of any Federal correctional facility 
        administrative proceeding.
    (d) Implementation.--The Attorney General and Bureau of Prisons 
shall implement this section according to established public health 
practices in a manner that protects the health, safety, and privacy of 
incarcerated persons and of correctional facility staff.

SEC. 4. SENSE OF CONGRESS REGARDING DISTRIBUTION OF SEXUAL BARRIER 
              PROTECTION DEVICES IN STATE PRISON SYSTEMS.

     It is the sense of Congress that States should allow for the legal 
distribution of sexual barrier protection devices in State correctional 
facilities to reduce the prevalence and spread of STIs in those 
facilities.

SEC. 5. SURVEY OF AND REPORT ON CORRECTIONAL FACILITY PROGRAMS AIMED AT 
              REDUCING THE SPREAD OF STIS.

    (a) Survey.--The Attorney General, after consulting with the 
Secretary of Health and Human Services, State officials, and community 
organizations, shall, to the maximum extent practicable, conduct a 
survey of all Federal and State correctional facilities no later than 
180 days after the date of enactment of this Act and annually 
thereafter for five years to determine:
            (1) Prevention education offered.--The type of prevention 
        education, information, or training offered to incarcerated 
        persons and correctional facility staff regarding sexual 
        violence and the spread of STIs, including whether such 
        education, information, or training--
                    (A) constitutes comprehensive sexuality education;
                    (B) is compulsory for new incarcerated persons and 
                for new staff; and
                    (C) is offered on an on-going basis.
            (2) Access to sexual barrier protection devices.--Whether 
        incarcerated persons can--
                    (A) possess sexual barrier protection devices;
                    (B) purchase sexual barrier protection devices;
                    (C) purchase sexual barrier protection devices at a 
                reduced cost; and
                    (D) obtain sexual barrier protection devices 
                without cost.
            (3) Incidence of sexual violence.--The incidence of sexual 
        violence and assault committed by incarcerated persons and by 
        correctional facility staff.
            (4) Counseling, treatment, and supportive services.--
        Whether the correctional facility requires incarcerated persons 
        to participate in counseling, treatment, and supportive 
        services related to STIs, or whether it offers such programs to 
        incarcerated persons.
            (5) STI testing.--Whether the correctional facility tests 
        incarcerated persons for STIs or gives them the option to 
        undergo such testing--
                    (A) at intake;
                    (B) on a regular basis; and
                    (C) prior to release.
            (6) STI test results.--The number of incarcerated persons 
        who are tested for STIs and the outcome of such tests at each 
        correctional facility, disaggregated to include results for--
                    (A) the type of sexually transmitted infection 
                tested for;
                    (B) the race and/or ethnicity of individuals 
                tested;
                    (C) the age of individuals tested; and
                    (D) the gender of individuals tested.
            (7) Pre-release referral policy.--Whether incarcerated 
        persons are informed prior to release about STI-related 
        services or other health services in their communities, 
        including free and low-cost counseling and treatment options.
            (8) Pre-release referrals made.--The number of referrals to 
        community-based organizations or public health facilities 
        offering STI-related or other health services provided to 
        incarcerated persons prior to release, and the type of 
        counseling or treatment for which the referral was made.
            (9) Other actions taken.--Whether the correctional facility 
        has taken any other action, in conjunction with community 
        organizations or otherwise, to reduce the prevalence and spread 
        of STIs in that facility.
    (b) Privacy.--In conducting the survey, the Attorney General shall 
not request or retain the identity of any person who has sought or been 
offered counseling, treatment, testing, or prevention education 
information regarding an STI (including information about sexual 
barrier protection devices), or who has tested positive for an STI.
    (c) Report.--The Attorney General shall transmit to Congress and 
make publicly available the results of the survey required under 
subsection (a), both for the Nation as a whole and disaggregated as to 
each State and each correctional facility. To the maximum extent 
possible, the Attorney General shall issue the first report no later 
than 1 year after the date of enactment of this Act and shall issue 
reports annually thereafter for 5 years.

SEC. 6. STRATEGY.

    (a) Directive to Attorney General.--The Attorney General, in 
consultation with the Secretary of Health and Human Services, State 
officials, and community organizations, shall develop and implement a 
5-year strategy to reduce the prevalence and spread of STIs in Federal 
and State correctional facilities. To the maximum extent possible, the 
strategy shall be developed, transmitted to Congress, and made publicly 
available no later than 180 days after the transmission of the first 
report required under subsection 5(c) of this Act.
    (b) Contents of Strategy.--The strategy shall include the 
following:
            (1) Prevention education.--A plan for improving prevention 
        education, information, and training offered to incarcerated 
        persons and correctional facility staff, including information 
        and training on sexual violence and the spread of STIs, and 
        comprehensive sexuality education.
            (2) Sexual barrier protection device access.--A plan for 
        expanding access to sexual barrier protection devices in 
        correctional facilities.
            (3) Sexual violence reduction.--A plan for reducing the 
        incidence of sexual violence among incarcerated persons and 
        correctional facility staff, developed in consultation with the 
        National Prison Rape Elimination Commission.
            (4) Counseling and supportive services.--A plan for 
        expanding access to counseling and supportive services related 
        to STIs in correctional facilities.
            (5) Testing.--A plan for testing incarcerated persons for 
        STIs during intake, during regular health exams, and prior to 
        release, and that--
                    (A) is conducted in accordance with guidelines 
                established by the Centers for Disease Control;
                    (B) includes pre-test counseling;
                    (C) requires that incarcerated persons are notified 
                of their option to decline testing at any time;
                    (D) requires that incarcerated persons are 
                confidentially notified of their test results in a 
                timely manner; and
                    (E) ensures that incarcerated persons testing 
                positive for STIs receive post-test counseling, care, 
                treatment and supportive services.
            (6) Treatment.--A plan for ensuring that correctional 
        facilities have the necessary medicine and equipment to treat 
        and monitor STIs and for ensuring that incarcerated persons 
        living with or testing positive for STIs receive and have 
        access to care and treatment services.
            (7) Strategies for demographic groups.--A plan for 
        developing and implementing culturally appropriate, sensitive, 
        and specific strategies to reduce the spread of STIs among 
        demographic groups heavily impacted by STIs.
            (8) Linkages with communities and facilities.--A plan for 
        establishing and strengthening linkages to local communities 
        and health facilities that provide counseling, testing, care, 
        and treatment services and that may receive persons recently 
        released from incarceration who are living with STIs.
            (9) Other plans.--Any other plans developed by the Attorney 
        General for reducing the spread of STIs or improving the 
        quality of health care in correctional facilities.
            (10) Monitoring system.--A monitoring system that 
        establishes performance goals related to reducing the 
        prevalence and spread of STIs in correctional facilities and 
        which, where feasible, expresses such goals in quantifiable 
        form.
            (11) Monitoring system performance indicators.--Performance 
        indicators that measure or assess the achievement of the 
        performance goals described in paragraph (9).
            (12) Cost estimate.--A detailed estimate of the funding 
        necessary to implement the strategy at the Federal and State 
        levels for all 5 years, including the amount of funds required 
        by community organizations to implement the parts of the 
        strategy in which they take part.
    (c) Report.--The Attorney General shall transmit to Congress and 
make publicly available an annual progress report regarding the 
implementation and effectiveness of the strategy described in 
subsection (a). The progress report shall include an evaluation of the 
implementation of the strategy using the monitoring system and 
performance indicators provided for in paragraphs (9) and (10) of 
subsection (b).

SEC. 7. APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated such sums 
as may be necessary to carry out this Act for each of the fiscal years 
2007 through 2013.
    (b) Availability of Funds.--Amounts made available under paragraph 
(1) are authorized to remain available until expended.

SEC. 8. DEFINITIONS.

    For the purposes of this Act:
            (1) Correctional facility.--The term ``correctional 
        facility'' means any prison, penitentiary, adult detention 
        facility, juvenile detention facility, jail, or other facility 
        to which persons may be sent after conviction of a crime or act 
        of juvenile delinquency within the United States.
            (2) Incarcerated person.--The term ``incarcerated person'' 
        means any person who is serving a sentence in a correctional 
        facility after conviction of a crime.
            (3) Sexually transmitted infection.--The term ``sexually 
        transmitted infection'' or ``STI'' means any disease or 
        infection that is commonly transmitted through sexual activity, 
        including HIV/AIDS, gonorrhea, chlamydia, syphilis, genital 
        herpes, viral hepatitis, and human papillomavirus.
            (4) Sexual barrier protection device.--The term ``sexual 
        barrier protection device'' means any FDA-approved physical 
        device which has not been tampered with and which reduces the 
        probability of STI transmission or infection between sexual 
        partners, including female condoms, male condoms, and dental 
        dams.
            (5) Comprehensive sexuality education.--The term 
        ``comprehensive sexuality education'' means sexuality education 
        that includes information about abstinence and about the proper 
        use and disposal of sexual barrier protection devices and which 
        is--
                    (A) based on evidence;
                    (B) free from bias; and
                    (C) comprehensive.
            (6) Community organization.--The term ``community 
        organization'' means a public health care facility or a non-
        profit organization which provides health or STI related 
        services according to established public health standards.
            (7) State.--The term ``State'' includes the District of 
        Columbia, American Samoa, the Commonwealth of the North Mariana 
        Islands, Guam, Puerto Rico, and the Virgin Islands of the 
        United States.
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