<enum>I</enum><header>Strengthening the Sexual Assault Examiner Workforce</header> <section id="HC88D95BF44844AB5B657CAE8BDA47D8F"><enum>101.</enum><header>Understanding sexual assault care</header> <subsection id="H7A9A72AD50624CD9BE20EDDD2294CC97"><enum>(a)</enum><header>Purpose</header><text>It is the purpose of this section to identify areas for improvement in health care delivery systems providing services to survivors of sexual assault.</text></subsection> <subsection id="H800549A0BF8E4C83B6D781734A0343A5"><enum>(b)</enum><header>Grants</header><text>The Secretary shall award grants to States to develop and implement State surveys to identify—</text> <paragraph id="H9D1DB2B822AD419A8FECAD0215AA8B0C"><enum>(1)</enum><text>the availability of and patient access to trained SAFE, SANE, and other providers who perform MFEs;</text></paragraph> <paragraph id="H898600426BCE41C297FE8CAF5535CF62"><enum>(2)</enum><text>the hospitals or clinics that offer MFEs and whether each hospital or clinic has full-time, part-time, or on-call coverage;</text></paragraph> <paragraph id="H792FABF9B1AD413D8C550ED7AEDAA88E"><enum>(3)</enum><text>regional, provider, or other barriers to access sexual assault care and services, including MFEs;</text></paragraph> <paragraph id="HF71F5D6910EF4B769F3D852D7D24F744"><enum>(4)</enum><text>billing and reimbursement practices for MFEs, including private health insurance, Medicare, Medicaid, the State’s victims compensation program, and any other crime funding or other sources of funding that contribute to payment for such examinations;</text></paragraph> <paragraph id="H16DE301E8E2F4809BC99E769761CE93F"><enum>(5)</enum><text>State requirements, minimum standards, and protocols for training sexual assault examiners;</text></paragraph> <paragraph id="H5875088986754B388DC78A4B009E82E4"><enum>(6)</enum><text>State requirements, minimum standards, and protocols for training non-SANE or SAFE emergency services personnel involved in MFEs;</text></paragraph> <paragraph id="H14E493FF8A0F4578B826850ACDB18A5C"><enum>(7)</enum><text>the availability of SAFE or SANE training, frequency of when training is convened, the providers of such training, the State’s role in such training, and what process or procedures are in place for continuing education of such examiners;</text></paragraph> <paragraph id="HE916EB7F253746FEA6B8D051387B582B"><enum>(8)</enum><text>the dedicated Federal and State funding to support SAFE or SANE training; and</text></paragraph> <paragraph id="HBDDFABA68E4B491EB52F88CB87F25C67"><enum>(9)</enum><text>funding opportunities for SANE or SAFE training and continuing education.</text></paragraph></subsection> <subsection id="H8D4C34800ED54538ACC69BF357D851D1"><enum>(c)</enum><header>Eligibility</header><text>To be eligible to receive a grant under this section, a State shall—</text> <paragraph id="H03FACD5BA7DD4874ACCFCF9428CC22B1"><enum>(1)</enum><text>have public, private, or nonprofit hospitals that receive Federal funding; and</text></paragraph> <paragraph id="H965ED33EB4E64E7FA1196B85F2291B51"><enum>(2)</enum><text>submit to the Secretary an application through a competitive process to be determined by the Secretary.</text></paragraph></subsection> <subsection id="H6D7DF37C7166470C9403876D82422A4A"><enum>(d)</enum><header>Public dissemination and campaign</header> <paragraph id="HABD55EEEC8FD41A6BA839D179657AC76"><enum>(1)</enum><header>Public availability</header><text>The results of the surveys conducted under grants awarded under this section shall be published by the Secretary on the website of the Department of Health and Human Services on a biennial basis.</text></paragraph> <paragraph id="HA1BD54BE4CEB4BA198878ED86467A308"><enum>(2)</enum><header>Campaigns</header><text>A State that receives a grant under this section shall carry out the following:</text> <subparagraph id="HD9FAA5F42330445B9038B89436B444C1"><enum>(A)</enum><text>Make the findings of the survey conducted under the grant public.</text></subparagraph> <subparagraph id="HB43B9F9EA1CB4044B77502A23409926A"><enum>(B)</enum><text>Use the findings to develop a strategic action plan to increase the number of trained examiners available in the State and create policies to increase survivor access to trained examiners.</text></subparagraph> <subparagraph id="H901433583557497CA959C78788D71F87"><enum>(C)</enum><text>Use the findings to develop and implement a public awareness campaign that includes the following:</text> <clause id="HF5675594F31A40439F5005889D5764E9"><enum>(i)</enum><text>An online toolkit describing how and where sexual assault survivors can obtain assistance and care, including MFEs, in the State.</text></clause> <clause id="H87FE0645CA744D2EBCDFA6F3A1221239"><enum>(ii)</enum><text>A Model Standard Response Protocol for health care providers to implement upon arrival of a patient seeking care for sexual assault.</text></clause> <clause id="H1FE1639521294B939245253F611DAEBA"><enum>(iii)</enum><text>A Model Sexual Assault Response Team Protocol incorporating interdisciplinary community coordination between hospitals, emergency departments, hospital administration, local rape crisis programs, law enforcement, prosecuting attorneys, and other health and human service agencies and stakeholders with respect to delivering survivor-centered sexual assault care and MFEs.</text></clause> <clause id="H12FAF5EAA9144A0F814398A939685241"><enum>(iv)</enum><text>A notice of State and Federal laws prohibiting charging or billing survivors of sexual assault for care and services related to sexual assault.</text></clause></subparagraph></paragraph></subsection> <subsection id="H8591E518C1514B33AD6A81BD70932005"><enum>(e)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section, $2,000,000 for each of fiscal years 2022 through 2027.</text></subsection></section> <section id="HF007C60B2A8E47BC818C77A0FA7CBBF4"><enum>102.</enum><header>Improving and strengthening the sexual assault examiner workforce clinical and continuing education pilot program</header> <subsection id="H22C23FBB76404C8CA6935D6C2CD51319"><enum>(a)</enum><header>Purpose</header><text>It is the purpose of this section to establish a pilot program to develop, test, and implement training and continuing education which expands and supports the availability of SAFE, SAE, and SANE, providers and services for survivors of sexual assault.</text></subsection> <subsection id="H4AD02135EE1345E6B5D3B38857100EED"><enum>(b)</enum><header>Establishment</header> <paragraph id="H99F7B0ADABB046CCA63B63F70201E2B0"><enum>(1)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this Act, the Secretary shall establish a National Continuing and Clinical Education Pilot Program for SAFEs, SANEs, and other individuals who perform such examinations in consultation with the Department of Justice, the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Indian Health Service, the Office for Victims of Crime of the Department of Justice, the Office on Violence Against Women of the Department of Justice, and the Office on Women’s Health of the Department of Health and Human Services and with input from regional and national organizations with expertise in forensic nursing, rape trauma or crisis counseling, investigating rape and gender violence cases, survivors’ advocacy and support, sexual assault prevention education, rural health, and responding to sexual violence in Native communities. Such pilot program shall be 2 years in duration.</text></paragraph> <paragraph id="H983D11E38DF2496E8143E117D9940DF4"><enum>(2)</enum><header>Functions</header><text>The pilot program established under paragraph (1) shall develop, pilot, implement, and update, as appropriate, continuing and clinical education program modules, webinars, and programs for all hospitals and providers to increase access to SANE and SAFE services and address ongoing competency issues in SAFE or SANE practice of care, including—</text> <subparagraph id="HDAB0C15F37304091A9F692D7011F6EE7"><enum>(A)</enum><text>training and continuing education to help support SAFEs or SANEs practicing in rural or underserved areas;</text></subparagraph> <subparagraph id="H9A2F9DF4A1C9450D838A6DAB2A4BDA28"><enum>(B)</enum><text>training to help connect sexual assault survivors who are Native American with SAFEs or SANEs, including through emergency first aid, referrals, culturally competent support, and forensic evidence collection in rural communities;</text></subparagraph> <subparagraph id="H42D22E1E617545DCAB8462CE75F74EA8"><enum>(C)</enum><text>replication of successful SANE or SAFE programs to help develop and improve the evidence base for MFEs; and</text></subparagraph> <subparagraph id="H07ECABDD70184E27BE97AD451133D27D"><enum>(D)</enum><text>training to increase the number of medical professionals who are considered SAFEs or SANEs based on the recommendations of the National Sexual Assault Forensic Examination Training Standards issued by the Department of Justice on Violence Against Women.</text></subparagraph></paragraph> <paragraph id="HDD5C0B8B51284010837BC14E65CE9421"><enum>(3)</enum><header>Eligibility to participate in pilot programs</header><text>The Secretary shall ensure that SAFE or SANE services provided under the pilot program established under paragraph (1), and other medical forensic examiner services under the pilot program shall be provided by health care providers who are also one of the following:</text> <subparagraph id="HBAEDAD2784C34FB8990F9DC0BFD3D1C9"><enum>(A)</enum><text>A physician, including a resident physician.</text></subparagraph> <subparagraph id="H3F490CDB15C9409999779AC129832482"><enum>(B)</enum><text>A nurse practitioner.</text></subparagraph> <subparagraph id="HC4991266DD264083BF5AD099CFDB8B9B"><enum>(C)</enum><text>A nurse midwife.</text></subparagraph> <subparagraph id="HDB7E4FF4F79C4DAEA5F6C647360CA737"><enum>(D)</enum><text>A physician assistant.</text></subparagraph> <subparagraph id="HB3E194F5AE7340F094350FDA0AFE2CEF"><enum>(E)</enum><text>A certified nurse specialist.</text></subparagraph> <subparagraph id="H3A122BCF1385456485F6CA10C8598E19"><enum>(F)</enum><text>A registered nurse.</text></subparagraph> <subparagraph id="HBBA5922F78A646CCAD4FBBCCFD417D1E"><enum>(G)</enum><text>A community health practitioner or a community health aide who has completed level III or level IV certification and training requirements.</text></subparagraph></paragraph> <paragraph id="H0E7ADC51419E431199CD7146ADA9B1C1"><enum>(4)</enum><header>Nature of training</header><text>The continuing education program established under this section shall incorporate and reflect current best practices and standards on MFEs consistent with the purpose of this section.</text></paragraph></subsection> <subsection id="H06F0F64A3FEF4600915F96871BE61CC7"><enum>(c)</enum><header>Availability</header><text>After termination of the pilot program established under subsection (b)(1), the training and continuing education program established under such program shall be available to all SAFEs, SANEs, and other providers employed by, or any individual providing services through, facilities that receive Federal funding. The Task Force established under section 201 shall review and recommend updates to the training and continuing education program after the termination of the pilot program.</text></subsection> <subsection id="HDC5816BB37F14F3AB58F3969FEC328CD"><enum>(d)</enum><header>Effective date</header> <paragraph id="H545A91216B9F4858A4DF7F2A6F79EC61"><enum>(1)</enum><header>In general</header><text>The pilot program established under this section shall terminate on the date that is 2 years after the date of such establishment.</text></paragraph> <paragraph id="HD4C43940A41642969C44F1A4F088CCE9"><enum>(2)</enum><header>Authority for modifications</header><text>Upon termination of the pilot program as provided for in paragraph (1), the Secretary or the Task Force established under section 201 may implement modifications relating to training and continuing education requirements based on such program to increase access to SANE and SAFE services for survivors of sexual assault.</text></paragraph></subsection> <subsection id="H46F0C37AE45643B19860B290B30D4501"><enum>(e)</enum><header>Authorization</header><text>There are authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2022 through 2024.</text></subsection></section> <section id="H29F65B334DEF401DA5F9A1269FE129D3"><enum>103.</enum><header>National report on sexual assault services in our nation’s health system</header> <subsection id="H6A9C3456CAE64469BAE614C95D4E6495"><enum>(a)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this Act, and annually thereafter, the Agency for Healthcare Research and Quality, in consultation with the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Indian Health Service, the Office for Victims of Crime of the Department of Justice, the Office on Women’s Health of the Department of Health and Human Services, and the Office of Violence Against Women of the Department of Justice (hereafter referred to in this section collectively as the <quote>Agencies</quote>), shall submit to the Secretary a report of existing Federal and State practices relating to SAFEs, SANEs, and others who perform such examinations which reflects the findings of the surveys developed under section 101.</text></subsection> <subsection id="H04B2132881564679B259C9C8F253D888"><enum>(b)</enum><header>Core competencies</header><text>In conducting activities under this section, the Agencies shall address SAFE or SANE competencies, including—</text> <paragraph id="H4583753BC4D346049E04A3C150E69A69"><enum>(1)</enum><text>providing comprehensive medical care to sexual assault patients;</text></paragraph> <paragraph id="HE143909EE10E420483FF6C1751892579"><enum>(2)</enum><text>demonstrating the ability to conduct a MFE to include an evaluation for evidence collection;</text></paragraph> <paragraph id="H036AFB83C0D74EF8BEE774ACAEBD6A40"><enum>(3)</enum><text>showing compassion and sensitivity towards survivors of sexual assault;</text></paragraph> <paragraph id="HC7E9D3796E584B13BC48A0FDC5F6F9E0"><enum>(4)</enum><text>testifying in Federal, State, local, and tribal courts; and</text></paragraph> <paragraph id="HB8483892296842F9885C7055814D1F08"><enum>(5)</enum><text>other competencies as determined appropriate by the Agencies.</text></paragraph></subsection> <subsection id="H85FC7D420B7D4354BBDCDE684EA25D68"><enum>(c)</enum><header>Publication</header> <paragraph id="H68BC08BC019B4369B718F26AC512DE81"><enum>(1)</enum><header>AHRQ</header><text>The Agency for Healthcare Research and Quality shall establish, maintain, and publish on the website of the Department of Health and Human Services an online public map of SAFE, SANE, and other forensic medical examiners. Such maps shall clarify if there is full-time, part-time, or on-call coverage.</text></paragraph> <paragraph id="H998815FF9252403794040C74FCE225CB"><enum>(2)</enum><header>States</header><text>A State that receives Federal funds shall maintain and make available an online public map displaying the number and location of available SAFE or SANE programs and other forensic medical examiners in the State. Such maps shall clarify if there is full-time, part-time, or on-call coverage.</text></paragraph></subsection></section> <section id="H8AC5BF3E09F6409BB6842A7ED9783FFD"><enum>104.</enum><header>Hospital reporting</header><text display-inline="no-display-inline">Not later than 1 year after the date of enactment of this Act, and annually thereafter, a hospital that receives Federal funds shall submit to the Secretary a report that identifies the level of community access provided by the hospital to trained SAFEs, SARTs, SANEs, and others who perform such examinations. Such report shall describe—</text> <paragraph id="HB4AA30F10D6B45DBB0335FFEE28B8CAD"><enum>(1)</enum><text>the number of sexual assault survivors who present at the hospital for MFEs in the year for which the report is being prepared;</text></paragraph> <paragraph id="H45C3E03FE83F4FB59D35ADA2F7AAA352"><enum>(2)</enum><text>the number of personnel who are trained and practicing as a SANE or SAFE to perform sexual assault exams, indicating the employment basis of such personnel as either full-time, part-time, or on-call;</text></paragraph> <paragraph id="H065E48E7A2AF482FB0C4660987A9F688"><enum>(3)</enum><text>the number of sexual assault exams performed by SANEs or SAFEs;</text></paragraph> <paragraph id="H82B6B6F5E74E4B5CB1DD24E5E4E24B23"><enum>(4)</enum><text>the number of sexual assault exams performed by personnel other than a SANE or SAFE;</text></paragraph> <paragraph id="H3E2E96241FF544029C9CF46306A83FD2"><enum>(5)</enum><text>the training that such SAFEs or SANEs undergo for purposes of maintaining competency; and</text></paragraph> <paragraph id="HB9785F0872A24AC4B784966C6D8F6752"><enum>(6)</enum><text>the SAFE/SANE standards of care applied by the hospital.</text></paragraph></section>

117 HR 2145 IH: Survivors’ Access to Supportive Care Act U.S. House of Representatives 2021-03-23 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

Short title

This Act may be cited as the

Survivors’ Access to Supportive Care Act

SASCA

Purpose

It is the purpose of this Act to increase access to medical forensic sexual assault examinations and treatment provided by sexual assault forensic examiners for survivors by identifying and addressing gaps in obtaining those services.

Definitions

In this Act: (1)

Community health aide and community health practitioner

The terms community health aide and community health practitioner have the meanings within the meaning of section 119 of the Indian Health Care Improvement Act (25 U.S.C. 1616l). (2)

MFE

The term medical forensic examination or MFE means an examination provided to a sexual assault survivor by medical personnel trained to gather evidence of a sexual assault in a manner suitable for use in a court of law. (3)

SAE

The term sexual assault examiner or SAE means a registered nurse, advanced practice nurse, physician, or physician assistant specifically trained to provide care to sexual assault forensic examinations. (4)

SAFE

The term sexual assault forensic examiner or SAFE means a medical practitioner who has specialized forensic training in treating sexual assault survivors and conducting medical forensic examinations. (5)

SANE

The term sexual assault nurse examiner or SANE means a registered nurse who has specialized forensic training in treating sexual assault survivors and conducting medical forensic examinations. (6)

SART

The term sexual assault response team or SART means a multidisciplinary team that provides a specialized and immediate response to survivors of sexual assault, and may include health care personnel, law enforcement representatives, community-based survivor advocates, prosecutors, and forensic scientists. (7)

Secretary

The term Secretary means the Secretary of Health and Human Services. (8)

Sexual assault

The term sexual assault means any nonconsensual sexual act proscribed by Federal, tribal, or State law, including when the individual lacks capacity to consent.

<enum>I</enum><header>Strengthening the Sexual Assault Examiner Workforce</header> <section id="HC88D95BF44844AB5B657CAE8BDA47D8F"><enum>101.</enum><header>Understanding sexual assault care</header> <subsection id="H7A9A72AD50624CD9BE20EDDD2294CC97"><enum>(a)</enum><header>Purpose</header><text>It is the purpose of this section to identify areas for improvement in health care delivery systems providing services to survivors of sexual assault.</text></subsection> <subsection id="H800549A0BF8E4C83B6D781734A0343A5"><enum>(b)</enum><header>Grants</header><text>The Secretary shall award grants to States to develop and implement State surveys to identify—</text> <paragraph id="H9D1DB2B822AD419A8FECAD0215AA8B0C"><enum>(1)</enum><text>the availability of and patient access to trained SAFE, SANE, and other providers who perform MFEs;</text></paragraph> <paragraph id="H898600426BCE41C297FE8CAF5535CF62"><enum>(2)</enum><text>the hospitals or clinics that offer MFEs and whether each hospital or clinic has full-time, part-time, or on-call coverage;</text></paragraph> <paragraph id="H792FABF9B1AD413D8C550ED7AEDAA88E"><enum>(3)</enum><text>regional, provider, or other barriers to access sexual assault care and services, including MFEs;</text></paragraph> <paragraph id="HF71F5D6910EF4B769F3D852D7D24F744"><enum>(4)</enum><text>billing and reimbursement practices for MFEs, including private health insurance, Medicare, Medicaid, the State’s victims compensation program, and any other crime funding or other sources of funding that contribute to payment for such examinations;</text></paragraph> <paragraph id="H16DE301E8E2F4809BC99E769761CE93F"><enum>(5)</enum><text>State requirements, minimum standards, and protocols for training sexual assault examiners;</text></paragraph> <paragraph id="H5875088986754B388DC78A4B009E82E4"><enum>(6)</enum><text>State requirements, minimum standards, and protocols for training non-SANE or SAFE emergency services personnel involved in MFEs;</text></paragraph> <paragraph id="H14E493FF8A0F4578B826850ACDB18A5C"><enum>(7)</enum><text>the availability of SAFE or SANE training, frequency of when training is convened, the providers of such training, the State’s role in such training, and what process or procedures are in place for continuing education of such examiners;</text></paragraph> <paragraph id="HE916EB7F253746FEA6B8D051387B582B"><enum>(8)</enum><text>the dedicated Federal and State funding to support SAFE or SANE training; and</text></paragraph> <paragraph id="HBDDFABA68E4B491EB52F88CB87F25C67"><enum>(9)</enum><text>funding opportunities for SANE or SAFE training and continuing education.</text></paragraph></subsection> <subsection id="H8D4C34800ED54538ACC69BF357D851D1"><enum>(c)</enum><header>Eligibility</header><text>To be eligible to receive a grant under this section, a State shall—</text> <paragraph id="H03FACD5BA7DD4874ACCFCF9428CC22B1"><enum>(1)</enum><text>have public, private, or nonprofit hospitals that receive Federal funding; and</text></paragraph> <paragraph id="H965ED33EB4E64E7FA1196B85F2291B51"><enum>(2)</enum><text>submit to the Secretary an application through a competitive process to be determined by the Secretary.</text></paragraph></subsection> <subsection id="H6D7DF37C7166470C9403876D82422A4A"><enum>(d)</enum><header>Public dissemination and campaign</header> <paragraph id="HABD55EEEC8FD41A6BA839D179657AC76"><enum>(1)</enum><header>Public availability</header><text>The results of the surveys conducted under grants awarded under this section shall be published by the Secretary on the website of the Department of Health and Human Services on a biennial basis.</text></paragraph> <paragraph id="HA1BD54BE4CEB4BA198878ED86467A308"><enum>(2)</enum><header>Campaigns</header><text>A State that receives a grant under this section shall carry out the following:</text> <subparagraph id="HD9FAA5F42330445B9038B89436B444C1"><enum>(A)</enum><text>Make the findings of the survey conducted under the grant public.</text></subparagraph> <subparagraph id="HB43B9F9EA1CB4044B77502A23409926A"><enum>(B)</enum><text>Use the findings to develop a strategic action plan to increase the number of trained examiners available in the State and create policies to increase survivor access to trained examiners.</text></subparagraph> <subparagraph id="H901433583557497CA959C78788D71F87"><enum>(C)</enum><text>Use the findings to develop and implement a public awareness campaign that includes the following:</text> <clause id="HF5675594F31A40439F5005889D5764E9"><enum>(i)</enum><text>An online toolkit describing how and where sexual assault survivors can obtain assistance and care, including MFEs, in the State.</text></clause> <clause id="H87FE0645CA744D2EBCDFA6F3A1221239"><enum>(ii)</enum><text>A Model Standard Response Protocol for health care providers to implement upon arrival of a patient seeking care for sexual assault.</text></clause> <clause id="H1FE1639521294B939245253F611DAEBA"><enum>(iii)</enum><text>A Model Sexual Assault Response Team Protocol incorporating interdisciplinary community coordination between hospitals, emergency departments, hospital administration, local rape crisis programs, law enforcement, prosecuting attorneys, and other health and human service agencies and stakeholders with respect to delivering survivor-centered sexual assault care and MFEs.</text></clause> <clause id="H12FAF5EAA9144A0F814398A939685241"><enum>(iv)</enum><text>A notice of State and Federal laws prohibiting charging or billing survivors of sexual assault for care and services related to sexual assault.</text></clause></subparagraph></paragraph></subsection> <subsection id="H8591E518C1514B33AD6A81BD70932005"><enum>(e)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section, $2,000,000 for each of fiscal years 2022 through 2027.</text></subsection></section> <section id="HF007C60B2A8E47BC818C77A0FA7CBBF4"><enum>102.</enum><header>Improving and strengthening the sexual assault examiner workforce clinical and continuing education pilot program</header> <subsection id="H22C23FBB76404C8CA6935D6C2CD51319"><enum>(a)</enum><header>Purpose</header><text>It is the purpose of this section to establish a pilot program to develop, test, and implement training and continuing education which expands and supports the availability of SAFE, SAE, and SANE, providers and services for survivors of sexual assault.</text></subsection> <subsection id="H4AD02135EE1345E6B5D3B38857100EED"><enum>(b)</enum><header>Establishment</header> <paragraph id="H99F7B0ADABB046CCA63B63F70201E2B0"><enum>(1)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this Act, the Secretary shall establish a National Continuing and Clinical Education Pilot Program for SAFEs, SANEs, and other individuals who perform such examinations in consultation with the Department of Justice, the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Indian Health Service, the Office for Victims of Crime of the Department of Justice, the Office on Violence Against Women of the Department of Justice, and the Office on Women’s Health of the Department of Health and Human Services and with input from regional and national organizations with expertise in forensic nursing, rape trauma or crisis counseling, investigating rape and gender violence cases, survivors’ advocacy and support, sexual assault prevention education, rural health, and responding to sexual violence in Native communities. Such pilot program shall be 2 years in duration.</text></paragraph> <paragraph id="H983D11E38DF2496E8143E117D9940DF4"><enum>(2)</enum><header>Functions</header><text>The pilot program established under paragraph (1) shall develop, pilot, implement, and update, as appropriate, continuing and clinical education program modules, webinars, and programs for all hospitals and providers to increase access to SANE and SAFE services and address ongoing competency issues in SAFE or SANE practice of care, including—</text> <subparagraph id="HDAB0C15F37304091A9F692D7011F6EE7"><enum>(A)</enum><text>training and continuing education to help support SAFEs or SANEs practicing in rural or underserved areas;</text></subparagraph> <subparagraph id="H9A2F9DF4A1C9450D838A6DAB2A4BDA28"><enum>(B)</enum><text>training to help connect sexual assault survivors who are Native American with SAFEs or SANEs, including through emergency first aid, referrals, culturally competent support, and forensic evidence collection in rural communities;</text></subparagraph> <subparagraph id="H42D22E1E617545DCAB8462CE75F74EA8"><enum>(C)</enum><text>replication of successful SANE or SAFE programs to help develop and improve the evidence base for MFEs; and</text></subparagraph> <subparagraph id="H07ECABDD70184E27BE97AD451133D27D"><enum>(D)</enum><text>training to increase the number of medical professionals who are considered SAFEs or SANEs based on the recommendations of the National Sexual Assault Forensic Examination Training Standards issued by the Department of Justice on Violence Against Women.</text></subparagraph></paragraph> <paragraph id="HDD5C0B8B51284010837BC14E65CE9421"><enum>(3)</enum><header>Eligibility to participate in pilot programs</header><text>The Secretary shall ensure that SAFE or SANE services provided under the pilot program established under paragraph (1), and other medical forensic examiner services under the pilot program shall be provided by health care providers who are also one of the following:</text> <subparagraph id="HBAEDAD2784C34FB8990F9DC0BFD3D1C9"><enum>(A)</enum><text>A physician, including a resident physician.</text></subparagraph> <subparagraph id="H3F490CDB15C9409999779AC129832482"><enum>(B)</enum><text>A nurse practitioner.</text></subparagraph> <subparagraph id="HC4991266DD264083BF5AD099CFDB8B9B"><enum>(C)</enum><text>A nurse midwife.</text></subparagraph> <subparagraph id="HDB7E4FF4F79C4DAEA5F6C647360CA737"><enum>(D)</enum><text>A physician assistant.</text></subparagraph> <subparagraph id="HB3E194F5AE7340F094350FDA0AFE2CEF"><enum>(E)</enum><text>A certified nurse specialist.</text></subparagraph> <subparagraph id="H3A122BCF1385456485F6CA10C8598E19"><enum>(F)</enum><text>A registered nurse.</text></subparagraph> <subparagraph id="HBBA5922F78A646CCAD4FBBCCFD417D1E"><enum>(G)</enum><text>A community health practitioner or a community health aide who has completed level III or level IV certification and training requirements.</text></subparagraph></paragraph> <paragraph id="H0E7ADC51419E431199CD7146ADA9B1C1"><enum>(4)</enum><header>Nature of training</header><text>The continuing education program established under this section shall incorporate and reflect current best practices and standards on MFEs consistent with the purpose of this section.</text></paragraph></subsection> <subsection id="H06F0F64A3FEF4600915F96871BE61CC7"><enum>(c)</enum><header>Availability</header><text>After termination of the pilot program established under subsection (b)(1), the training and continuing education program established under such program shall be available to all SAFEs, SANEs, and other providers employed by, or any individual providing services through, facilities that receive Federal funding. The Task Force established under section 201 shall review and recommend updates to the training and continuing education program after the termination of the pilot program.</text></subsection> <subsection id="HDC5816BB37F14F3AB58F3969FEC328CD"><enum>(d)</enum><header>Effective date</header> <paragraph id="H545A91216B9F4858A4DF7F2A6F79EC61"><enum>(1)</enum><header>In general</header><text>The pilot program established under this section shall terminate on the date that is 2 years after the date of such establishment.</text></paragraph> <paragraph id="HD4C43940A41642969C44F1A4F088CCE9"><enum>(2)</enum><header>Authority for modifications</header><text>Upon termination of the pilot program as provided for in paragraph (1), the Secretary or the Task Force established under section 201 may implement modifications relating to training and continuing education requirements based on such program to increase access to SANE and SAFE services for survivors of sexual assault.</text></paragraph></subsection> <subsection id="H46F0C37AE45643B19860B290B30D4501"><enum>(e)</enum><header>Authorization</header><text>There are authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2022 through 2024.</text></subsection></section> <section id="H29F65B334DEF401DA5F9A1269FE129D3"><enum>103.</enum><header>National report on sexual assault services in our nation’s health system</header> <subsection id="H6A9C3456CAE64469BAE614C95D4E6495"><enum>(a)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this Act, and annually thereafter, the Agency for Healthcare Research and Quality, in consultation with the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Indian Health Service, the Office for Victims of Crime of the Department of Justice, the Office on Women’s Health of the Department of Health and Human Services, and the Office of Violence Against Women of the Department of Justice (hereafter referred to in this section collectively as the <quote>Agencies</quote>), shall submit to the Secretary a report of existing Federal and State practices relating to SAFEs, SANEs, and others who perform such examinations which reflects the findings of the surveys developed under section 101.</text></subsection> <subsection id="H04B2132881564679B259C9C8F253D888"><enum>(b)</enum><header>Core competencies</header><text>In conducting activities under this section, the Agencies shall address SAFE or SANE competencies, including—</text> <paragraph id="H4583753BC4D346049E04A3C150E69A69"><enum>(1)</enum><text>providing comprehensive medical care to sexual assault patients;</text></paragraph> <paragraph id="HE143909EE10E420483FF6C1751892579"><enum>(2)</enum><text>demonstrating the ability to conduct a MFE to include an evaluation for evidence collection;</text></paragraph> <paragraph id="H036AFB83C0D74EF8BEE774ACAEBD6A40"><enum>(3)</enum><text>showing compassion and sensitivity towards survivors of sexual assault;</text></paragraph> <paragraph id="HC7E9D3796E584B13BC48A0FDC5F6F9E0"><enum>(4)</enum><text>testifying in Federal, State, local, and tribal courts; and</text></paragraph> <paragraph id="HB8483892296842F9885C7055814D1F08"><enum>(5)</enum><text>other competencies as determined appropriate by the Agencies.</text></paragraph></subsection> <subsection id="H85FC7D420B7D4354BBDCDE684EA25D68"><enum>(c)</enum><header>Publication</header> <paragraph id="H68BC08BC019B4369B718F26AC512DE81"><enum>(1)</enum><header>AHRQ</header><text>The Agency for Healthcare Research and Quality shall establish, maintain, and publish on the website of the Department of Health and Human Services an online public map of SAFE, SANE, and other forensic medical examiners. Such maps shall clarify if there is full-time, part-time, or on-call coverage.</text></paragraph> <paragraph id="H998815FF9252403794040C74FCE225CB"><enum>(2)</enum><header>States</header><text>A State that receives Federal funds shall maintain and make available an online public map displaying the number and location of available SAFE or SANE programs and other forensic medical examiners in the State. Such maps shall clarify if there is full-time, part-time, or on-call coverage.</text></paragraph></subsection></section> <section id="H8AC5BF3E09F6409BB6842A7ED9783FFD"><enum>104.</enum><header>Hospital reporting</header><text display-inline="no-display-inline">Not later than 1 year after the date of enactment of this Act, and annually thereafter, a hospital that receives Federal funds shall submit to the Secretary a report that identifies the level of community access provided by the hospital to trained SAFEs, SARTs, SANEs, and others who perform such examinations. Such report shall describe—</text> <paragraph id="HB4AA30F10D6B45DBB0335FFEE28B8CAD"><enum>(1)</enum><text>the number of sexual assault survivors who present at the hospital for MFEs in the year for which the report is being prepared;</text></paragraph> <paragraph id="H45C3E03FE83F4FB59D35ADA2F7AAA352"><enum>(2)</enum><text>the number of personnel who are trained and practicing as a SANE or SAFE to perform sexual assault exams, indicating the employment basis of such personnel as either full-time, part-time, or on-call;</text></paragraph> <paragraph id="H065E48E7A2AF482FB0C4660987A9F688"><enum>(3)</enum><text>the number of sexual assault exams performed by SANEs or SAFEs;</text></paragraph> <paragraph id="H82B6B6F5E74E4B5CB1DD24E5E4E24B23"><enum>(4)</enum><text>the number of sexual assault exams performed by personnel other than a SANE or SAFE;</text></paragraph> <paragraph id="H3E2E96241FF544029C9CF46306A83FD2"><enum>(5)</enum><text>the training that such SAFEs or SANEs undergo for purposes of maintaining competency; and</text></paragraph> <paragraph id="HB9785F0872A24AC4B784966C6D8F6752"><enum>(6)</enum><text>the SAFE/SANE standards of care applied by the hospital.</text></paragraph></section> <enum>II</enum><header>Standards of care</header> <section id="H7DD9723441B84AA18758ADB2910FF1B3"><enum>201.</enum><header>National Sexual Assault Care and Treatment Task Force</header> <subsection commented="no" display-inline="no-display-inline" id="H01ABD3B8208C4A39955E744EAE09EBE5"><enum>(a)</enum><header>Establishment</header><text>The Secretary shall establish a task force to be known as the <quote>SASCA Task Force</quote> (referred to in this section as the <quote>Task Force</quote>) to identify barriers to improving access to SAFE/SANE and other forensic medical examiners.</text></subsection> <subsection id="H03B685824FFD4646BD02E39E6E4B002F"><enum>(b)</enum><header>Membership</header><text>The Task Force shall include a representative from the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Indian Health Service, the Office for Victims of Crime of the Department of Justice, the Office on Women’s Health of the Department of Health and Human Services, and the Office on Violence Against Women of the Department of Justice, a survivor of sexual assault, and representatives from regional and national organizations with expertise in forensic nursing, rape trauma or crisis counseling, investigating rape and gender violence cases, survivors’ advocacy and support, sexual assault prevention education, rural health, and responding to sexual violence in Native communities.</text></subsection> <subsection id="HCB0620BF6C19486EB34BD5E78B5C7F94"><enum>(c)</enum><header>Objectives</header><text>To assist and standardize State-level efforts to improve medical forensic evidence collection relating to sexual assault, the Task Force shall—</text> <paragraph id="H3C6EF5EF5EEF4BC98B1B2CD10BABD407"><enum>(1)</enum><text>identify barriers to the recruitment, training, and retention of SAFEs, SARTs, SANEs, and others who perform such examinations;</text></paragraph> <paragraph id="H1AB6698866F042FDA4942B5C2C549C4D"><enum>(2)</enum><text>make recommendations for improving access to medical forensic examinations, including the feasibility of, or barriers to, utilizing mobile units;</text></paragraph> <paragraph id="H3B087F2774B9458F8E8F176F1D58DB90"><enum>(3)</enum><text>improve coordination of services, and other protocols regarding the care and treatment of sexual assault survivors and the preservation of evidence between law enforcement officials and health care providers; and</text></paragraph> <paragraph id="H7A04DBC3321B48CA8EAD8FA04D4E893D"><enum>(4)</enum><text>update national minimum standards for forensic medical examiner training and forensic medical evidence collection relating to sexual assault.</text></paragraph></subsection> <subsection id="HDF6AEBDE2EF74CB5BC204189DF0D9B5B"><enum>(d)</enum><header>Transparency requirements</header> <paragraph id="HEAB128B359464825805D2FDD90B272FC"><enum>(1)</enum><header>In general</header><text>Not later than 1 year after first convening, the Task Force shall report to the Secretary in a public document on—</text> <subparagraph id="HA485A904891F44EBA6A09F8968C75F5A"><enum>(A)</enum><text>the recommendation for best practices with respect to improving medical forensic evidence collection relating to sexual assault; and</text></subparagraph> <subparagraph id="HD18FCB9F6B1A409A80F8FBF4AAB3ECBC"><enum>(B)</enum><text>the national minimum standards for MFEs and treatments relating to sexual assault.</text></subparagraph></paragraph> <paragraph id="H4C48E914FEA44A70A9077775F10956D1"><enum>(2)</enum><header>Report</header><text>Not later than 18 months after the date of enactment of this Act, the Secretary shall submit to Congress a report on the findings and conclusions of the Task Force.</text></paragraph></subsection> <subsection id="H3453AEB101C34473B902DD5D313794E3"><enum>(e)</enum><header>Annual summit</header><text>The Secretary shall convene an annual stakeholder meeting to address gaps in health care provider care relating to sexual assault that includes the Task Force.</text></subsection></section> <section commented="no" id="HF2885A8DB6E94FB08882A4A1F14F8AA9"><enum>202.</enum><header>Institutions of higher education campus action plan</header><text display-inline="no-display-inline">Each institution of higher education that receives Federal funds shall—</text> <paragraph commented="no" id="HC9C3809C91CC44F59E59A2A527C42CA5"><enum>(1)</enum><text display-inline="yes-display-inline">inform survivors of sexual assault about the availability of MFEs, including the nearest available locations at which such examinations are provided by a SANE and that Federal law requires such exams to be provided at no cost to the survivor; and</text></paragraph> <paragraph commented="no" id="H42E7AD63992F4477BA426E5832644BD1"><enum>(2)</enum><text display-inline="yes-display-inline">make the information described in paragraph (1) available on the website of the institution, to the extent practicable.</text></paragraph></section> <section id="H7DCE308065CA41F4AC8894CA582AAE24"><enum>203.</enum><header>Expanding access to unified care</header><text display-inline="no-display-inline">Part B of title VIII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/296j">42 U.S.C. 296j</external-xref> et seq.) is amended by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="H3AB9E7A6BA5043ACA08CEF5E99FB598D" style="OLC"> <section id="HA1612D62095E42C9BCF221DE7FC071D9"><enum>812.</enum><header>Demonstration grants for sexual assault examiner training programs</header> <subsection id="H7B53497E2AF04A58A8AEFE8BE845B6E3"><enum>(a)</enum><header>Establishment of program</header><text>The Secretary shall establish a demonstration program (referred to in this section as the <quote>program</quote>) to award grants to eligible partnered entities for the clinical training of SAFEs/SANEs (including registered nurses, nurse practitioners, nurse midwives, clinical nurse specialists, physician assistants, and physicians) to administer medical forensic examinations and treatments to survivors of sexual assault.</text></subsection> <subsection id="H403437D9905C4CBB93883D133043E2FE"><enum>(b)</enum><header>Purpose</header><text>The purpose of the program is to enable each grant recipient to expand access to SAFE/SANE services by providing new providers with the clinical training necessary to establish and maintain competency in SAFE/SANE services and to test the provisions of such services at new facilities in expanded health care settings.</text></subsection> <subsection id="H352B71E5047846F9A35D80B2DBC8B798"><enum>(c)</enum><header>Grants</header><text>Under the program, the Secretary shall award 3-year grants to eligible entities that meet the requirements established by the Secretary.</text></subsection> <subsection id="H2B6C661F3C2E4B788A6668F1ABD76FA2"><enum>(d)</enum><header>Eligible entities</header><text>To be eligible to receive a grant under this section, an entity shall—</text> <paragraph id="H6BBCBF1D9C9747F0AA8A5F88316996EF"><enum>(1)</enum><text>be—</text> <subparagraph id="H6226E6CF250D4047A3050C7818ED3980"><enum>(A)</enum><text>a rural health care services provider or community-based service provider (as defined by the Secretary), a center or clinic under section 330, or a health center receiving assistance under title X, acting in partnership with a high-volume emergency services provider or a hospital currently providing sexual assault medical forensic examinations performed by SANEs or SAFEs, that will use grant funds to—</text> <clause id="H5B3CBAEEF64147F284C29E1472DC5DC7"><enum>(i)</enum><text>assign rural health care service providers to the high-volume hospitals for clinical practicum hours to qualify such providers as a SAFE/SANE; or</text></clause> <clause id="HE8C17F672FB94B9B90E4DDEFC60E526A"><enum>(ii)</enum><text>assign practitioners at high-volume hospitals to a rural health care services providers to instruct, oversee, and approve clinical practicum hours in the community to be served; or</text></clause></subparagraph> <subparagraph id="HAE4345472E5B4BECAD8750F8931A6878"><enum>(B)</enum><text>an organization described in <external-xref legal-doc="usc" parsable-cite="usc/26/501">section 501(c)(3)</external-xref> of the Internal Revenue Code of 1986 and exempt from taxation under 501(a) of that Act, that provides legal training and technical assistance to tribal communities and to organizations and agencies serving Native people; and</text></subparagraph></paragraph> <paragraph id="H0FE3EE80FCDF4F9DA41EE54EA5120868"><enum>(2)</enum><text>submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including a description of whether the applicant will provide services under subparagraph (A) or (B) of paragraph (1).</text></paragraph></subsection> <subsection id="HDD8469CDF1BE4F3789693ED65382CEA6"><enum>(e)</enum><header>Grant amount</header><text>Each grant awarded under this section shall be in an amount not to exceed $400,000 per year. A grant recipient may carry over funds from one fiscal year to the next without obtaining approval from the Secretary.</text></subsection> <subsection id="HCD10AED9AF244255A619C598E6484C9C"><enum>(f)</enum><header>Authorization of appropriations</header> <paragraph id="H4FED9DBA260D4533A59B1A37CE9ADF48"><enum>(1)</enum><header>In general</header><text>There is authorized to be appropriated to carry out this section $11,000,000 for each of fiscal years 2022 through 2027.</text></paragraph> <paragraph id="H4E9A64CD5CF542E18B256268C647B16E"><enum>(2)</enum><header>Set-aside</header><text>Of the amount appropriated under this subsection for a fiscal year, the Secretary shall reserve 15 percent of such amount for purposes of making grants to entities that are affiliated with Indian tribes or tribal organizations (as defined in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>)), or Urban Indian organizations (as defined in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>)). Amounts reserved may be used to support referrals and the delivery of emergency first aid, culturally competent support, and forensic evidence collection training.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="HEA40FAB9A33C46F5B563868DF48A56A1"><enum>204.</enum><header>Technical assistance grants and learning collectives</header><text display-inline="no-display-inline">Part B of title VIII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/296j">42 U.S.C. 296j</external-xref> et seq.), as amended by section 203, is further amended by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="H3B564CFB534344EFA6339D8A7289F18A" style="OLC"> <section id="H80EF84656C214F76BD916115A5FDBB90"><enum>812A.</enum><header>Technical assistance center and regional learning collectives</header> <subsection id="HEDBEAFA8032F40C6B18ACF81F2934236"><enum>(a)</enum><header>In general</header><text>The Secretary shall establish a State and provider technical resource center to provide technical assistance to health care providers to increase the quality of, and access to, MFEs by entering into contracts with national experts (such as the International Forensic Nurses Association and others).</text></subsection> <subsection id="H733FFF93B38448618C245E55B1B3C1C9"><enum>(b)</enum><header>Regional learning collectives</header><text>The Secretary shall convene State and hospital regional learning collectives to assist health care providers and States in sharing best practices, discussing practices, and improving the quality of, and access to, MFEs.</text></subsection> <subsection id="H1304E7211BFB4491BD94D284FCC262CF"><enum>(c)</enum><header>Repository</header><text>The Secretary shall establish and maintain a secure Internet-based data repository to serve as an online learning collective for State and entity collaborations. An entity receiving a grant under section 812 may use such repository for—</text> <paragraph id="H254DC05E538842C99346F7FF60B0D676"><enum>(1)</enum><text>technical assistance; and</text></paragraph> <paragraph id="H567BE3BF8C264E608A6DDEE04D380077"><enum>(2)</enum><text>best practice sharing.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H662F415EA78D42398A8BA680DB185F8A"><enum>205.</enum><header>Quality strategies</header><text display-inline="no-display-inline">The Secretary shall identify SAFE/SANE access and quality in hospitals and other appropriate health care facilities as a national priority for improvement under section 399HH(a)(2) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/280j">42 U.S.C. 280j(a)(2)</external-xref>).</text></section> <section id="HE2F9B2EF3FBD450EAD6B0367DA1CF053"><enum>206.</enum><header>Oversight</header><text display-inline="no-display-inline">Not later than one year after the date of enactment of this Act, the Office of the Inspector General shall issue a report concerning hospital compliance with section 1867 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395dd">42 U.S.C. 1395dd</external-xref>) and the Violence Against Women Act of 1994 (<external-xref legal-doc="usc" parsable-cite="usc/34/12291">34 U.S.C. 12291</external-xref> et seq.) with respect to access to, and reimbursements for, sexual assault medical forensic examinations at the national, State, and individual hospital level. Such report shall address hospital awareness of reimbursements, total reimbursed costs, and any costs for survivors.</text></section>