[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1765 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                S. 1765

To amend the Public Health Service Act to provide grants to strengthen 
the healthcare system's response to domestic violence, dating violence, 
                     sexual assault, and stalking.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 31, 2011

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

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to provide grants to strengthen 
the healthcare system's response to domestic violence, dating violence, 
                     sexual assault, and stalking.

    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 ``Consolidation of Grants to 
Strengthen the Healthcare System's Response to Domestic Violence, 
Dating Violence, Sexual Assault, and Stalking Act''.

SEC. 2. STRENGTHENING THE HEALTHCARE SYSTEM'S RESPONSE TO DOMESTIC 
              VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND STALKING.

    (a) In General.--Section 399P of the Public Health Service Act (42 
U.S.C. 280g-4) is amended to read as follows:

``SEC. 399A. GRANTS TO STRENGTHEN THE HEALTHCARE SYSTEM'S RESPONSE TO 
              DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND 
              STALKING.

    ``(a) In General.--The Secretary, acting through the Office of 
Women's Health, shall award grants for--
            ``(1) the development or enhancement, and implementation of 
        interdisciplinary training for health professionals, public 
        health staff, and allied health professionals;
            ``(2) the development or enhancement, and implementation of 
        education programs for medical, nursing, dental, and other 
        health professions students and residents to prevent and 
        respond to domestic violence, dating violence, sexual assault, 
        and stalking; and
            ``(3) the development or enhancement, and implementation of 
        comprehensive Statewide strategies to improve the response of 
        clinics, public health facilities, hospitals, and other health 
        settings (including behavioral and mental health programs) to 
        domestic violence, dating violence, sexual assault, and 
        stalking.
    ``(b) Use of Funds.--
            ``(1) Required uses.--Amounts provided under a grant under 
        subsection (a) shall be used to--
                    ``(A) fund interdisciplinary training and education 
                programs under paragraphs (1) and (2) of subsection (a) 
                that--
                            ``(i) are designed to train medical, 
                        psychology, dental, social work, nursing, and 
                        other health professions students, interns, 
                        residents, fellows, or current health care 
                        providers 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 been victims of domestic violence, 
                        dating violence, sexual assault, or stalking; 
                        and
                            ``(ii) plan and develop culturally 
                        competent clinical training components for 
                        integration into approved internship, 
                        residency, and fellowship training or 
                        continuing medical or other health education 
                        training that address physical, mental, and 
                        behavioral health issues, including protective 
                        factors, related to domestic violence, dating 
                        violence, sexual assault, stalking, and other 
                        forms of violence and abuse, focus on reducing 
                        health disparities and preventing violence and 
                        abuse, and include the primacy of victim safety 
                        and confidentiality; and
                    ``(B) design and implement comprehensive strategies 
                to improve the response of the health care system to 
                domestic or sexual violence in clinical and public 
                health settings, hospitals, clinics, and other health 
                settings (including behavioral and mental health), 
                under subsection (a)(3) through--
                            ``(i) implementation, dissemination, and 
                        evaluation of policies and procedures to guide 
                        health professionals and public health staff in 
                        identifying and responding to domestic 
                        violence, dating violence, sexual assault, 
                        stalking, including strategies to ensure that 
                        health information is maintained in a manner 
                        that protects the patient's privacy and safety, 
                        and safely uses health information technology 
                        to improve documentation, identification, 
                        assessment, treatment, and follow-up care;
                            ``(ii) development of on-site access to 
                        services to address the safety, medical, and 
                        mental health needs of patients by increasing 
                        the capacity of existing health care 
                        professionals and public health staff to 
                        address domestic violence, dating violence, 
                        sexual assault, and stalking, or by contracting 
                        with or hiring domestic or sexual assault 
                        advocates to provide such services or to model 
                        other services appropriate to the geographic 
                        and cultural needs of a site;
                            ``(iii) development of measures and methods 
                        for the identification of risk and protective 
                        factors and evaluation of identification, 
                        intervention, and documentation regarding 
                        victims of domestic violence, dating violence, 
                        sexual assault, sexual coercion, and stalking, 
                        including the development and testing of 
                        quality improvement measurements; and
                            ``(iv) provision of training and follow-up 
                        technical assistance to health care 
                        professionals, and public health staff, and 
                        allied health professionals to identify, 
                        assess, treat, and refer clients who are 
                        victims of domestic violence, dating violence, 
                        sexual assault, sexual coercion, or stalking, 
                        including using tools and training materials 
                        already developed.
            ``(2) Permissible uses.--
                    ``(A) Child and elder abuse.--To the extent 
                consistent with the purpose of this section, a grantee 
                under this section may address, as part of a 
                comprehensive programmatic approach implemented under a 
                grant under this section, issues relating to child or 
                elder abuse.
                    ``(B) Other uses of funds.--With respect to--
                            ``(i) grants awarded under paragraphs (1) 
                        and (2) of subsection (a), grant funds may be 
                        used to--
                                    ``(I) offer to rural areas 
                                community-based training opportunities, 
                                which may include the use of distance 
                                learning networks and other available 
                                technologies needed to reach isolated 
                                rural areas, for medical, nursing, and 
                                other health professions students and 
                                residents on domestic violence, dating 
                                violence, sexual assault, stalking, 
                                and, as appropriate, other forms of 
                                violence and abuse; or
                                    ``(II) provide stipends to students 
                                who are underrepresented in the health 
                                professions as necessary to promote and 
                                enable their participation in 
                                clerkships, internships, or other 
                                offsite training experiences that are 
                                designed to develop health care 
                                clinical skills related to domestic 
                                violence, dating violence, sexual 
                                assault, stalking; and
                            ``(ii) grants awarded under subsection 
                        (a)(1), grant funds may be used for--
                                    ``(I) development of training 
                                modules and policies that document and 
                                address the overlap of child abuse, 
                                domestic violence, dating violence, 
                                sexual assault, sexual coercion, and 
                                stalking and elder abuse, as well as 
                                childhood exposure to domestic and 
                                sexual violence;
                                    ``(II) development, expansion, and 
                                implementation of sexual assault 
                                forensic medical examination or sexual 
                                assault nurse examiner programs;
                                    ``(III) inclusion of the health 
                                effects of lifetime exposure to 
                                violence and abuse as well as related 
                                protective factors and behavioral risk 
                                factors in health professional training 
                                schools including medical, dental, 
                                nursing, social work, and mental and 
                                behavioral health curricula, and allied 
                                health service training courses; or
                                    ``(IV) integration of knowledge of 
                                domestic violence, dating violence, 
                                sexual assault, sexual coercion, and 
                                stalking into health care accreditation 
                                and professional licensing 
                                examinations, such as medical, dental, 
                                social work, and nursing boards, and 
                                where appropriate, other allied health 
                                exams.
    ``(c) Requirements for Grantees.--
            ``(1) Confidentiality and safety.--
                    ``(A) In general.--Grantees under this section 
                shall ensure that all programs developed with grant 
                funds address issues of confidentiality and patient 
                safety and comply with applicable confidentiality and 
                nondisclosure requirements under section 40002(b)(2) of 
                the Violence Against Women Act of 1994 (42 U.S.C. 
                13925(b)(2)) and the Family Violence Prevention and 
                Services Act (42 U.S.C. 10401 et seq.), and that 
                faculty and staff associated with delivering 
                educational components are fully trained in procedures 
                that will protect the immediate and ongoing security 
                and confidentiality of the patients, patient records, 
                and staff. Such grantees shall consult entities with 
                demonstrated expertise in the confidentiality and 
                safety needs of victims of domestic violence, dating 
                violence, sexual assault, and stalking on the 
                development and adequacy of confidentially and security 
                procedures, and provide documentation of such 
                consultation.
                    ``(B) Advance notice of information disclosure.--
                Grantees under this section shall provide to patients 
                advance notice about any circumstances under which 
                information may be disclosed, such as mandatory 
                reporting laws, and shall give patients the option to 
                receive information and referrals without affirmatively 
                disclosing abuse.
            ``(2) Application.--
                    ``(A) Preference.--In selecting grant recipients 
                under this section, the Secretary shall give preference 
                to applicants based on the strength of their evaluation 
                strategies, with outcome based evaluations, broadly 
                defined and prioritized.
                    ``(B) Grants under subsection (a) (1) or (2).--An 
                entity desiring a grant under paragraph (1) or (2) of 
                subsection (a) shall submit an application to the 
                Secretary at such time, in such a manner, and 
                containing such information and assurances as the 
                Secretary may require, including--
                            ``(i) documentation that the applicant 
                        represents a team of entities, including 
                        someone with evaluation or research expertise, 
                        working collaboratively to strengthen the 
                        response of the health care system to domestic 
                        violence, dating violence, sexual assault, or 
                        stalking, and which includes at least one of 
                        each of--
                                    ``(I) an accredited school of 
                                allopathic or osteopathic medicine, 
                                psychology, nursing, dental, social 
                                work, or other health field; or a 
                                health care facility or system; and
                                    ``(II) a government or nonprofit 
                                entity with a history of effective work 
                                in the fields of domestic violence, 
                                dating violence, sexual assault, or 
                                stalking; and
                            ``(ii) strategies for the dissemination and 
                        sharing of curricula and other educational 
                        materials developed under the grant, if any, 
                        with other interested health professions 
                        schools and national resource repositories for 
                        materials on domestic violence, dating 
                        violence, sexual assault, and stalking;
                    ``(C) Grants under subsection (a)(3).--An entity 
                desiring a grant under subsection (a)(3) shall submit 
                an application to the Secretary at such time, in such a 
                manner, and containing such information and assurances 
                as the Secretary may require, including--
                            ``(i) documentation that all training, 
                        education, screening, assessment, services, 
                        treatment, and any other approach to patient 
                        care will be informed by an understanding and 
                        dynamics of violence and abuse victimization 
                        and trauma-specific approaches and these 
                        approaches will be integrated into research, 
                        prevention, intervention, and treatment 
                        activities;
                            ``(ii) strategies for the development and 
                        implementation of policies to prevent and 
                        address domestic violence, dating violence, 
                        sexual assault, and stalking over the lifespan 
                        in health care settings;
                            ``(iii) a plan for consulting with State 
                        and tribal domestic violence or sexual assault 
                        coalitions, national nonprofit victim advocacy 
                        organizations, State or tribal law enforcement 
                        task forces (where appropriate), and culturally 
                        specific organizations with demonstrated 
                        expertise in domestic violence, dating 
                        violence, sexual assault, or stalking; and
                            ``(iv) with respect to an application for a 
                        grant--
                                    ``(I) under which the grantee will 
                                have contact with patients, a plan, 
                                developed in collaboration with local 
                                victim service providers, to respond 
                                appropriately to and make correct 
                                referrals for individuals who disclose 
                                that they are victims of domestic 
                                violence, dating violence, sexual 
                                assault, stalking, or other types of 
                                violence (such grantees shall provide 
                                documentation of an ongoing 
                                collaborative relationship with a local 
                                victim service provider); or
                                    ``(II) proposing to fund a program 
                                described in subsection 
                                (b)(2)(B)(ii)(II), a certification that 
                                any sexual assault forensic medical 
                                examination and sexual assault nurse 
                                examiner programs supported with such 
                                grant funds will adhere to the 
                                guidelines set forth in the Attorney 
                                General's National Protocol for Sexual 
                                Assault Medical Forensic Examinations 
                                (Adults/Adolescents).
    ``(d) Eligible Entities.--
            ``(1) Grants under subsection (a) (1) or (2).--To be 
        eligible to receive funding under paragraph (1) or (2) of 
        subsection (a), an entity shall be--
                    ``(A) a nonprofit organization with a history of 
                effective work in the field of training health 
                professionals with an understanding of, and clinical 
                skills pertinent to, domestic violence, dating 
                violence, sexual assault, or stalking, and lifetime 
                exposure to violence and abuse;
                    ``(B) an accredited school of allopathic or 
                osteopathic medicine, psychology, nursing, dental, 
                social work, or allied health;
                    ``(C) a health care provider membership or 
                professional organization, or a health care system; or
                    ``(D) a State, tribal, territorial, or local 
                entity.
            ``(2) Grants under subsection (a)(3).--To be eligible to 
        receive funding under subsection (a)(3), an entity shall be--
                    ``(A) a State department (or other division) of 
                health, a State, tribal, or territorial domestic 
                violence or sexual assault coalition or victim services 
                program, or any other nonprofit, nongovernmental 
                organization with a history of effective work in the 
                fields of domestic violence, dating violence, sexual 
                assault, or stalking, and health care, including 
                physical or mental health care; or
                    ``(B) a local victim service provider, a local 
                department (or other division) of health, a local 
                health clinic, hospital, or health system, or any other 
                community-based organization with a history of 
                effective work in the field of domestic violence, 
                dating violence, sexual assault, or stalking and health 
                care, including physical or mental health care.
    ``(e) Technical Assistance.--
            ``(1) In general.--Of the funds made available to carry out 
        this section for any fiscal year, the Secretary may make a 
        grant or enter into a contract to provide technical assistance 
        with respect to the planning, development, and operation of any 
        program, activity, or service carried out pursuant to this 
        section. Not to exceed 8 percent of the funds appropriated 
        under this section for a fiscal year may be used to fund 
        technical assistance, unless the Secretary has previously set 
        aside amounts greater than 8 percent for technical assistance 
        and training relating to grant programs authorized under this 
        section.
            ``(2) Availability of materials.--The Secretary shall make 
        publicly available materials developed by grantees under this 
        section, including materials on training, best practices, and 
        research and evaluation.
            ``(3) Reporting.--The Secretary shall publish a biennial 
        report on--
                    ``(A) the distribution of funds under this section; 
                and
                    ``(B) the programs and activities supported by such 
                funds.
    ``(f) Research and Evaluation.--
            ``(1) In general.--Of the funds made available to carry out 
        this section for any fiscal year, the Secretary may use not to 
        exceed 20 percent to make a grant or enter into a contract for 
        research and evaluation of--
                    ``(A) grants awarded under this section; and
                    ``(B) other training for health professionals and 
                effective interventions in the health care setting that 
                prevent domestic violence, dating violence, and sexual 
                assault across the lifespan, prevent the health effects 
                of such violence, and improve the safety and health of 
                individuals who are currently being victimized.
            ``(2) Research.--Research authorized in paragraph (1) may 
        include--
                    ``(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 health status of 
                individuals, families, and populations;
                    ``(B) research to determine effective health care 
                interventions to respond to and prevent domestic 
                violence, dating violence, sexual assault, and sexual 
                coercion;
                    ``(C) research on the impact of domestic, dating 
                and sexual violence, childhood exposure to such 
                violence, and stalking on the health care system, 
                health care utilization, health care costs, and health 
                status; and
                    ``(D) research on the impact of adverse childhood 
                experiences on adult experience with domestic violence, 
                dating violence, sexual assault, stalking and adult 
                health outcomes, including how to reduce or prevent the 
                impact of adverse childhood experiences through the 
                health care setting.
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2012 through 2016.
    ``(h) Definitions.--Except as otherwise provided, the definitions 
in section 40002 of the Violence Against Women Act of 1994 (42 U.S.C. 
13925) shall apply to this section.''.
    (b) Repeals.--The following provisions are repealed:
            (1) Section 758 of the Public Health Service Act (42 U.S.C. 
        294h).
            (2) Section 40297 of the Violence Against Women Act of 1994 
        (42 U.S.C. 13973).
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