[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2704 Introduced in House (IH)]
112th CONGRESS
1st Session
H. R. 2704
To reduce the spread of sexually transmitted infections in correctional
facilities, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 29, 2011
Ms. Lee of California introduced the following bill; which was referred
to the Committee on the Judiciary, and in addition to the Committee on
Energy and Commerce, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
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'' or
the ``JUSTICE Act''.
SEC. 2. FINDINGS.
The Congress makes the following findings:
(1) According to the Bureau of Justice Statistics (BJS),
2,292,133 persons were incarcerated in the United States as of
the end of 2009. Between 1998 and 2008, the number of persons
incarcerated in Federal or State correctional facilities
increased by an average of 2.4 percent per year. One in every
32 United States residents was on probation, in jail or prison,
or on parole at the end of 2009.
(2) As of 2009, 66.8 percent of incarcerated persons were
racial or ethnic minorities. Based on current incarceration
rates, BJS estimates that African-American males are 6 times
more likely to be held in custody than White males, while
Hispanic males are a little more than 2 times more likely to be
held in custody. Across all age categories, African-American
males were incarcerated at higher rates than Hispanic or 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 has determined that the rate of confirmed AIDS cases is 2.4
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 2.8 times more likely than White
incarcerated persons and 1.4 times more likely than Hispanic
incarcerated persons to die from AIDS-related causes. Nearly
two-thirds of AIDS-related deaths are among Black, non-Hispanic
males.
(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 that approximately 4.4 percent of incarcerated persons
in prisons and 3.1 percent of persons in jail reported
experiencing one or more incidents of sexual victimization by
another incarcerated person or correctional facility staff in
the previous year.
(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, Washington DC, and Philadelphia also
allow condom distribution in their correctional facilities.
However, these States and cities operate fewer than 1 percent
of all correctional facilities.
(10) A 2007 report by the Massachusetts General Hospital
Division of Infectious Diseases and the University of
California, San Francisco, found that the proportion of
European prison systems allowing condoms rose from 53 percent
in 1989 to 81 percent in 1997. The same report also found that
no prison system allowing the distribution of condoms had
reversed their decision, and no prison system reported an
increase in sexual activity among incarcerated persons as a
result of a decision to allow condom distribution.
(11) 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.
(12) 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.
(13) 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 2005,
only 996 of the 1,821 Federal and State correctional facilities
(i.e. 54.7 percent) provided HIV/AIDS counseling programs.
(14) Individuals who are enrolled in Medicaid prior to
incarceration face a suspension of their benefits upon
incarceration, and in some States a termination of their
Medicaid eligibility. The Federal Government encourages States
to automatically re-enroll incarcerated persons on Medicaid
upon their release from a correctional facility, unless the
State reaches a determination that the individual is no longer
eligible for reasons other than their prior incarceration.
(15) Formerly incarcerated individuals who are newly
released from correctional facilities often face delays in the
resumption of their Medicaid benefits which may exacerbate any
health issues which they face.
(16) Incarcerated individuals living with HIV/AIDS who are
eligible for Medicaid would benefit from prompt and automatic
enrollment upon their release in order to ensure their
continued ability to access health services, including
antiretroviral treatment.
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. AUTOMATIC REINSTATEMENT OF MEDICAID BENEFITS.
(a) In General.--Section 1902(e) of the Social Security Act (42
U.S.C. 1396a(e)) is amended by adding at the end the following:
``(15) Enrollment of ex-offenders.--
``(A) Automatic enrollment or reinstatement.--
``(i) In general.--The State plan shall
provide for the automatic enrollment or
reinstatement of enrollment of an eligible
individual--
``(I) if such individual is
scheduled to be released from a public
institution due to the completion of
sentence, not less than 30 days prior
to the scheduled date of the release;
and
``(II) if such individual is to be
released from a public institution on
parole or on probation, as soon as
possible after the date on which the
determination to release such
individual was made, and before the
date such individual is released.
``(ii) Exception.--If a State makes a
determination that an individual is not
eligible to be enrolled under the State plan--
``(I) on or before the date by
which the individual would be enrolled
under clause (i), such clause shall not
apply to such individual; or
``(II) after such date, the State
may terminate the enrollment of such
individual.
``(B) Relationship of enrollment to payment for
services.--
``(i) In general.--Subject to subparagraph
(A)(ii), an eligible individual who is
enrolled, or whose enrollment is reinstated,
under subparagraph (A) shall be eligible for
medical assistance that is provided after the
date that the eligible individual is released
from the public institution
``(ii) Relationship to payment prohibition
for inmates.--No provision of this paragraph
may be construed to permit payment for care or
services for which payment is excluded under
subparagraph (A), following paragraph (29), in
section 1905(a).
``(C) Treatment of continuous eligibility.--
``(i) Suspension for inmates.--Any period
of continuous eligibility under this title
shall be suspended on the date an individual
enrolled under this title becomes an inmate of
a public institution (except as a patient of a
medical institution).
``(ii) Determination of remaining period.--
Notwithstanding any changes to State law
related to continuous eligibility during the
time that an individual is an inmate of a
public institution (except as a patient of a
medical institution), subject to clause (iii),
with respect to an eligible individual who was
subject to a suspension under subclause (I), on
the date that such individual is released from
a public institution the suspension of
continuous eligibility under such subclause
shall be lifted for a period that is equal to
the time remaining in the period of continuous
eligibility for such individual on the date
that such period was suspended under such
subclause.
``(iii) Exception.--If a State makes a
determination that an individual is not
eligible to be enrolled under the State plan--
``(I) on or before the date that
the suspension of continuous
eligibility is lifted under clause
(ii), such clause shall not apply to
such individual; or
``(II) after such date, the State
may terminate the enrollment of such
individual.
``(D) Automatic enrollment or reinstatement of
enrollment defined.--For purposes of this paragraph,
the term `automatic enrollment or reinstatement of
enrollment' means that the State determines eligibility
for medical assistance under the State plan without a
program application from, or on behalf of, the eligible
individual, but an individual can only be automatically
enrolled in the State Medicaid plan if the individual
affirmatively consents to being enrolled through
affirmation in writing, by telephone, orally, through
electronic signature, or through any other means
specified by the Secretary.
``(E) Eligible individual defined.--For purposes of
this paragraph, the term `eligible individual' means an
individual who is an inmate of a public institution
(except as a patient in a medical institution)--
``(i) who was enrolled under the State plan
for medical assistance immediately before
becoming an inmate of such an institution; or
``(ii) is diagnosed with human
immunodeficiency virus.''.
(b) Supplemental Funding for State Implementation of Automatic
Reinstatement of Medicaid Benefits.--
(1) In general.--Subject to paragraph (6), for each State
for which the Secretary of Health and Human Services has
approved an application under paragraph (3), the Federal
matching payments (including payments based on the Federal
medical assistance percentage) made to such State under section
1903 of the Social Security Act (42 U.S.C. 1396b) (excluding
any increase resulting from the application of section 5001 of
Public Law 111-5) shall be increased by 5.0 percentage points
for payments to the State for the activities permitted under
paragraph (2) for a period of one year.
(2) Use of funds.--A State may only use increased matching
payments authorized under paragraph (1)--
(A) to strengthen the State's enrollment and
administrative resources for the purpose of improving
processes for enrolling (or reinstating the enrollment
of) eligible individuals (as such term is defined in
section 1902(e)(15)(E) of the Social Security Act); and
(B) for medical assistance (as such term is defined
in section 1905(a) of the Social Security Act) provided
to such eligible individuals.
(3) Application and agreement.--The Secretary may only make
payments to a State in the increased amount if--
(A) the State has amended the State plan under
section 1902 of the Social Security Act to incorporate
the requirements of subsection (e)(15) of such section;
(B) the State has submitted an application to the
Secretary that includes a plan for implementing the
requirements of section 1902(e)(15) of the Social
Security Act under the State's amended State plan
before the end of the 90-day period beginning on the
date that the State receives increased matching
payments under paragraph (1);
(C) the State's application meets the satisfaction
of the Secretary; and
(D) the State enters an agreement with the
Secretary that states that--
(i) the State will only use the increased
matching funds for the uses permitted under
paragraph (2); and
(ii) at the end of the period under
paragraph (1), the State will submit to the
Secretary, and make publicly available, a
report that contains the information required
under paragraph (4).
(4) Required report information.--The information that is
required in the report under paragraph (3)(D)(ii) includes--
(A) the results of an evaluation of the impact of
the implementation of the requirements of section
1902(e)(15) of the Social Security Act on improving the
State's processes for enrolling of individuals who are
released for public institutions into the Medicaid
program;
(B) the number of individuals who were
automatically enrolled (or whose enrollment is
reinstated) under such section 1902(e)(15) during the
period under paragraph (1); and
(C) any other information that is required by the
Secretary.
(5) Increase in cap on medicaid payments to territories.--
Subject to paragraph (6), the amounts otherwise determined for
Puerto Rico, the United States Virgin Islands, Guam, the
Northern Mariana Islands, and American Samoa under subsections
(f) and (g) of section 1108 of the Social Security Act (42 6
U.S.C. 1308) shall each be increased by the necessary amount to
allow for the increase in the Federal matching payments under
paragraph (1), but only for the period under such paragraph for
such State. In the case of such an increase for a territory,
subsection (a)(1) of such section 1108 shall be applied without
regard to any increase in payment made to the territory under
part E of title IV of such Act that is attributable to the
increase in Federal medical assistance percentage effected
under paragraph (1) for the territory.
(6) Limitations.--
(A) Timing.--With respect to a State, at the end of
the period under paragraph (1), no increased matching
payments may be made to such State under this
subsection.
(B) Maintenance of eligibility.--
(i) In general.--Subject to clause (ii), a
State is not eligible for an increase in its
Federal matching payments under paragraph (1),
or an increase in a cap amount under paragraph
(5), if eligibility standards, methodologies,
or procedures under its State plan under title
XIX of the Social Security Act (including any
waiver under such title or under section 1115
of such Act (42 U.S.C. 1315)) are more
restrictive than the eligibility standards,
methodologies, or procedures, respectively,
under such plan (or waiver) as in effect on the
date of enactment of this Act.
(ii) State reinstatement of eligibility
permitted.--A State that has restricted
eligibility standards, methodologies, or
procedures under its State plan under title XIX
of the Social Security Act (including any
waiver under such title or under section 1115
of such Act (42 U.S.C. 1315)) after the date of
enactment of this Act, is no longer ineligible
under clause (i) beginning with the first
calendar quarter in which the State has
reinstated eligibility standards,
methodologies, or procedures that are no more
restrictive than the eligibility standards,
methodologies, or procedures, respectively,
under such plan (or waiver) as in effect on
such date.
(C) No waiver authority.--The Secretary may not
waive the application of this subsection under section
1115 of the Social Security Act or otherwise.
(D) Limitation of matching payments to 100
percent.--In no case shall an increase in Federal
matching payments under this subsection result in
Federal matching payments that exceed 100 percent.
(c) Effective Date.--
(1) In general.--Except as provided in paragraph (2), the
amendments made by subsection (a) shall take effect 180 days
after the date of the enactment of this Act and shall apply to
services furnished on or after such date.
(2) Rule for changes requiring state legislation.--In the
case of a State plan for medical assistance under title XIX of
the Social Security Act which the Secretary of Health and Human
Services determines requires State legislation (other than
legislation appropriating funds) in order for the plan to meet
the additional requirement imposed by the amendments made by
this subsection, the State plan shall not be regarded as
failing to comply with the requirements of such title solely on
the basis of its failure to meet this additional requirement
before the first day of the first calendar quarter beginning
after the close of the first regular session of the State
legislature that begins after the date of the enactment of this
Act. For purposes of the previous sentence, in the case of a
State that has a 2-year legislative session, each year of such
session shall be deemed to be a separate regular session of the
State legislature.
SEC. 6. 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 5 years, to determine the following:
(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 ongoing 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) Reinstatement of medicaid benefits.--Whether the
correctional facility assists incarcerated persons that were
enrolled in the State Medicaid program prior to their
incarceration, in reinstating their enrollment upon release and
whether such individuals receive referrals as provided by
paragraph (8) to entities that accept the State Medicaid
program, including if applicable--
(A) the number of such individuals, including those
diagnosed with the human immunodeficiency virus, that
have been reinstated;
(B) a list of obstacles to reinstating enrollment
or to making determinations of eligibility for
reinstatement, if any; and
(C) the number of individuals denied enrollment.
(10) 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. 7. 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 section 6(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 and
Prevention;
(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--
(A) provide counseling, testing, care, and
treatment services;
(B) may receive persons recently released from
incarceration who are living with STIs; and
(C) accept payment through the State Medicaid
program.
(9) Enrollment in state medicaid programs.--Plans to ensure
that incarcerated persons who were--
(A) enrolled in their State Medicaid program prior
to incarceration in a correctional facility are
automatically re-enrolled in such program upon their
release; and
(B) not enrolled in their State Medicaid program
prior to incarceration, but who are diagnosed with the
human immunodeficiency virus while incarcerated in a
correctional facility, are automatically enrolled in
such program upon their release.
(10) 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.
(11) 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.
(12) Monitoring system performance indicators.--Performance
indicators that measure or assess the achievement of the
performance goals described in paragraph (9).
(13) 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. 8. 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
2012 through 2018.
(b) Availability of Funds.--Amounts made available under paragraph
(1) are authorized to remain available until expended.
SEC. 9. DEFINITIONS.
For the purposes of this Act:
(1) Community organization.--The term ``community
organization'' means a public health care facility or a
nonprofit organization which provides health- or STI-related
services according to established public health standards.
(2) 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) evidence-based;
(B) medically accurate;
(C) age and developmentally appropriate;
(D) gender and identity sensitive;
(E) culturally and linguistically appropriate; and
(F) structured to promote critical thinking, self-
esteem, respect for others, and the development of
healthy attitudes and relationships.
(3) 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.
(4) Incarcerated person.--The term ``incarcerated person''
means any person who is serving a sentence in a correctional
facility after conviction of a crime.
(5) 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.
(6) 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.
(7) State.--The term ``State'' includes the District of
Columbia, American Samoa, the Commonwealth of the Northern
Mariana Islands, Guam, Puerto Rico, and the United States
Virgin Islands.
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