[Congressional Record Volume 148, Number 47 (Wednesday, April 24, 2002)]
[Senate]
[Pages S3304-S3305]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. WELLSTONE:
  S. 2236. A bill to amend title III of the Public Health Service Act 
to provide coverage for domestic violence screening and treatment, to 
authorize the Secretary of Health and Human Services to make grants to 
improve the response of health care systems to domestic violence, and 
train health care providers and federally qualified health centers 
regarding screening, identification, and treatment for families 
experiencing domestic violence; to the Committee on Health, Education, 
Labor, and Pensions.
  Mr. WELLSTONE. Madam President, I rise today to introduce the 
Domestic Violence Screening and Services Act of 2002, an act to improve 
the response of health care systems to domestic violence, and to train 
health care providers and federally qualified health centers regarding 
screening, identification, and treatment for families experiencing 
domestic violence.
  Nearly one third of American women, 31 percent, report being 
physically or sexually abused by a husband or boyfriend at some point 
in their lives, and about 1200 women are murdered every year by their 
intimate partner, nearly 3 each day. 37 percent of all women who sought 
care in hospital emergency rooms for violence related injuries were 
injured by a current or former spouse, boyfriend, or girlfriend. In 
addition to injuries sustained during violent episodes, physical and 
psychological abuse are linked to numerous adverse health effects 
including arthritis, chronic neck or back pain, migraine and other 
frequent headaches, problems with vision, and sexually transmitted 
infections, including HIV/AIDS.
  Each year, at least 6 percent of all pregnant women, about 240,000 
pregnant women in this country, are battered by the men in their lives. 
This battering leads to complications in pregnancy, including low 
weight gain, anemia, infections, and first and second trimester 
bleeding. Pregnant women are more likely to die of homicide than to die 
of any other cause.
  Currently, about 10 percent of primary care physicians routinely 
screen for intimate partner abuse during new patient visits and 9 
percent routinely screen during periodic checkups. Recent clinical 
studies have shown the effectiveness of a 2-minute screening for early 
detection of abuse of pregnant women. Additional longitudinal studies 
have tested a 10-minute intervention that was highly effective in 
increasing the safety of pregnant abused women. 70 to 81 percent of 
patients studied reported that they would like their health care 
providers to ask them privately about intimate partner violence.
  Medical services for abused women cost an estimated $857,300,000 
every year. It is time for us to also authorize resources to promote 
the effort to make screening for domestic violence routine in health 
care settings. This bill would establish domestic violence prevention 
grants in the amount of $5 million dollars per year to improve 
screening and treatment for domestic violence in federally qualified 
health centers. Grants could be used for the implementation, 
dissemination, and evaluation of policies and procedures to guide 
health care professionals and staff to respond to domestic violence. 
Grants could also be used to provide training and follow-up technical 
assistance to health professionals and staff to screen for domestic 
violence, and then to appropriately assess, treat, and refer patients 
who are victims of domestic violence to domestic violence service 
providers. In addition, grants could be used for the development of 
onsite access to services to address, the safety, medical, and mental 
health needs of patients either by increasing the capacity of existing 
health professionals and staff to address these issues or by 
contracting with or hiring domestic violence advocates to provide the 
services.
  This bill would also authorize the Secretary of Health and Human 
Services to award grants in the amount of $5 million per year to 
strengthen the response of State and local health care systems to 
domestic violence by building the capacity of health personnel to 
identify, address, and prevent domestic violence. Up to 10 grants would 
be utilized to design and implement comprehensive statewide strategies 
in clinical and public healthcare settings and to promote education and 
awareness about domestic violence at a statewide

[[Page S3305]]

level. Up to 10 additional grants would be used to design and implement 
comprehensive local strategies to improve the response of the health 
care system in hospitals, clinics, managed care settings, emergency 
medical services, and other health care settings.
  Finally, this bill would also ensure that health care professionals 
working in the National Health Service Corps receiving training on how 
to screen, assess, treat and refer patients who are victims of domestic 
violence. Our health care system represents a potentially life saving 
point of intervention for those experiencing domestic violence. We need 
to support these efforts to improve the ability of our health care 
system to be a safe place for women to turn to when most in need.
  Madam President, I ask unanimous consent that a summary of the bill 
be printed in the Record.
  There being no objection, the summary was ordered to be printed in 
the Record, as follows:

   Summary--The Domestic Violence Screening and Services Act of 2002


                                overview

       The Domestic Violence Screening and Services Act of 2002 
     would create domestic violence prevention grants to improve 
     screening and treatment for patients at Federally Qualified 
     Health Centers. The bill would also provide grants to 
     strengthen the response of State and local health care 
     systems to domestic violence and would ensure that health 
     care professionals working in the National Health Service 
     Corps receive training on how to screen, assess, treat, and 
     render patients who are victims of domestic violence.


                   federally qualified health centers

       In an effort to increase screening and access to services 
     for these patients who are or may be experiencing domestic 
     violence the bill amends Part P of title III of the Public 
     Health Service Act by adding a new Sec. 3990 creating 
     Domestic Violence Prevention Grants in the amount of 5 
     million dollars per year for four years.
       Funds would be used to design and implement comprehensive 
     local strategies to improve the health care response to 
     domestic violence in federally qualified health centers. 
     These strategies would include: the development, 
     implementation, dissemination, and evaluation of policies and 
     procedures to guide health care professionals and staff 
     responding to domestic violence; the provision of training 
     and follow-up technical assistance to health care 
     professionals and staff to screen for domestic violence, and 
     then to appropriately assess, record in medical records, 
     treat, and refer patients who are victims of domestic 
     violence to domestic violence services; the development of 
     on-site access to services to address the safety, medical, 
     mental health, and economic needs of patients either by 
     increasing the capacity of existing health care 
     professionals and staff to address these issues or by 
     contracting with or hiring domestic violence advocates to 
     provide the services.


Grants for Domestic Violence Screening and Treatment in State and Local 
                           healthcare Systems

       The Secretary of Health and Human Services acting through 
     the Assistant Secretary for the Administration for Children 
     and Families shall award grants to fund 10 demonstration 
     projects at the state level and 10 demonstration grants on 
     the local level to develop comprehensive strategies to 
     improve the response of the healtcare system to domestic 
     violence. Recommended authorization is $5 million/year for 
     four years.
       Eligible entities--would be: A. a State or local health 
     department, nonprofit State domestic violence coalition or 
     local service-based program, State professional medical 
     society, State health professional association, or other 
     nonprofit or State entity with a history of effective work in 
     the field of domestic violence; that can B. demonstrate that 
     it is representing a team of organizations and agencies 
     working collaboratively to strengthen the health care 
     system's response to domestic violence and that such team 
     includes domestic violence and health care organizations.
       Use of funds--Funds would be used to design and implement 
     comprehensive statewide and local strategies to improve the 
     health care response to domestic violence in hospitals, 
     clinics, managed care settings, emergency medical services, 
     and other health care settings. These strategies would 
     include: the development, implementation, dissemination, and 
     evaluation of policies and procedures to guide health care 
     professionals and staff responding to domestic violence; the 
     provision of training and follow-up technical assistance to 
     health care professionals and staff to screen for domestic 
     violence, and then to appropriately assess, record in medical 
     records, treat, and refer patients who are victims of 
     domestic violence the domestic violence services; the 
     implementation of practice guidelines for routine screening 
     and recording mechanisms to identify and document domestic 
     violence; the development of on-site access to services to 
     address the safety, medical, mental health, and economic 
     needs of patients either by increasing the capacity of 
     existing health care professionals and staff to address these 
     issues or by contracting with or hiring domestic violence 
     advocates to provide the services or other model appropriate 
     to the geographic and cultural needs of a site.
       In additional required that health care professionals 
     trained through the National Health Service Corps receiving 
     in domestic violence screening and treatment.
                                 ______