[Congressional Record (Bound Edition), Volume 161 (2015), Part 1]
[House]
[Pages 1252-1255]
[From the U.S. Government Publishing Office, www.gpo.gov]




       TRAFFICKING AWARENESS TRAINING FOR HEALTH CARE ACT OF 2015

  Mrs. ELLMERS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 398) to provide for the development and dissemination of 
evidence-based best practices for health care professionals to 
recognize victims of a severe form of trafficking and respond to such 
individuals appropriately, and for other purposes.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 398

       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 ``Trafficking Awareness 
     Training for Health Care Act of 2015''.

     SEC. 2. DEVELOPMENT OF BEST PRACTICES.

       (a) Grant for Development of Best Practices.--Not later 
     than 1 year after the date of enactment of this Act, the 
     Secretary of Health and Human Services, acting through the 
     Director of the Agency for Healthcare Research and Quality 
     and in consultation with the Administrator of the Health 
     Resources and Services Administration, shall award, on a 
     competitive basis, a grant to an eligible school under which 
     such school will--
       (1) not later than 6 months after receipt of the award, 
     develop best practices for health care professionals--
       (A) to recognize victims of a severe form of trafficking; 
     and
       (B) to respond appropriately to such individuals;
       (2) in developing best practices under paragraph (1), 
     survey, analyze, and evaluate, in consultation with law 
     enforcement personnel, social service providers, and other 
     experts in the field of human trafficking, existing best 
     practices that foster the practice of interprofessional 
     collaboration, including those used by industries other than 
     the health care industry, to determine the extent to which 
     such existing best practices may be adapted for use as part 
     of the best practices under paragraph (1);
       (3) develop curricula, training modules, or materials to 
     train health care professionals on the best practices 
     developed under paragraph (1);
       (4) not later than 12 months after the receipt of the 
     award, make a subgrant to one entity located near an 
     established anti-human trafficking task force initiative in 
     each of the 10 administrative regions of the Department of 
     Health and Human Services--
       (A) to design, implement, and evaluate a pilot program 
     using the best practices developed under paragraph (1) and 
     the curricula, training modules, or materials developed under 
     paragraph (3);
       (B) to conduct the pilot program at one or more eligible 
     sites within the respective region, which may include an 
     eligible site that is a school-based health center; and
       (C) to complete the implementation and evaluation of such 
     pilot program within a period of 6 months;
       (5) not later than 24 months after the receipt of the 
     award, analyze the results of the pilot programs conducted 
     through subgrants under paragraph (4), including analyzing--
       (A) changes in the skills, knowledge, and attitude of 
     health care professionals resulting from the implementation 
     of the programs;
       (B) the number of victims of a severe form of trafficking 
     who are recognized under the programs;
       (C) of those recognized, the number who received 
     information or referrals for services offered through the 
     programs; and
       (D) of those who received such information or referrals--
       (i) the number who participated in followup services; and

[[Page 1253]]

       (ii) the type of followup services received;
       (6) determine, using the results of the analysis under 
     paragraph (5), the extent to which the best practices 
     developed under paragraph (1) are evidence-based; and
       (7) submit a comprehensive assessment of the pilot programs 
     conducted through subgrants under paragraph (4) to the 
     Secretary of Health and Human Services, including an 
     identification of--
       (A) the best practices that are determined pursuant to 
     paragraph (6) to be evidence-based; and
       (B) the best practices that are determined pursuant to such 
     paragraph to require further review in order to determine 
     whether they are evidence-based.
       (b) Contents.--The best practices developed through the 
     grant awarded under subsection (a)--
       (1) shall address--
       (A) risk factors and indicators to recognize victims of a 
     severe form of trafficking;
       (B) application of Federal and State law, including 
     reporting requirements, with respect to victims of a severe 
     form of trafficking;
       (C) patient safety and security, including the requirements 
     of HIPAA privacy and security law as applied to victims of a 
     severe form of trafficking;
       (D) the management of medical records of patients who are 
     victims of a severe form of trafficking;
       (E) public and private social services available for 
     rescue, food, clothing, and shelter referrals;
       (F) the hotlines for reporting human trafficking maintained 
     by the National Human Trafficking Resource Center and the 
     Department of Homeland Security;
       (G) validated assessment tools for the identification of 
     victims of a severe form of trafficking; and
       (H) referral options and procedures for sharing information 
     on human trafficking with a patient and making referrals for 
     legal and social service assistance related to human 
     trafficking when indicated and appropriate; and
       (2) shall not address patient medical treatment.
       (c) Dissemination.--Not later than 24 months after the 
     award of a grant to a school under subsection (a), the 
     Secretary of Health and Human Services, acting through the 
     Administrator of the Agency for Healthcare Research and 
     Quality, shall--
       (1) post on the public website of the Department of Health 
     and Human Services the best practices that are identified by 
     the school under subparagraphs (A) and (B) of subsection 
     (a)(7); and
       (2) disseminate to health care profession schools the best 
     practices identified by the school under subsection (a)(7)(A) 
     and evaluation results.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) The term ``eligible site'' means a health center that 
     is receiving assistance under section 330, 399Z-1, or 1001 of 
     the Public Health Service Act (42 U.S.C. 254b, 300).
       (2) The term ``eligible school'' means an accredited school 
     of medicine or nursing with experience in the study or 
     treatment of victims of a severe form of trafficking.
       (3) The term ``health care professional'' means a person 
     employed by a health care provider who provides to patients 
     information (including information not related to medical 
     treatment), scheduling, services, or referrals.
       (4) The term ``HIPAA privacy and security law'' has the 
     meaning given to such term in section 3009 of the Public 
     Health Service Act (42 U.S.C. 300jj-19).
       (5) The term ``victim of a severe form of trafficking'' has 
     the meaning given to such term in section 103 of the 
     Trafficking Victims Protection Act of 2000 (22 U.S.C. 7102).

     SEC. 4. NO ADDITIONAL AUTHORIZATION OF APPROPRIATIONS.

       No additional funds are authorized to be appropriated to 
     carry out this Act and the amendments made by this Act, and 
     this Act and such amendments shall be carried out using 
     amounts otherwise available for such purpose.

  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
North Carolina (Mrs. Ellmers) and the gentleman from New Jersey (Mr. 
Pallone) each will control 20 minutes.
  The Chair recognizes the gentlewoman from North Carolina.


                             General Leave

  Mrs. ELLMERS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from North Carolina?
  There was no objection.
  Mrs. ELLMERS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today to acknowledge the ongoing domestic problem 
with human trafficking. H.R. 398, the Trafficking Awareness Training 
for Health Care Act, will create a program dedicated to training our 
Nation's health care professionals in order to identify the early 
warning signs for the act of human trafficking.
  Oftentimes, members of the medical community encounter these 
individuals while they are still being trafficked. By training health 
care professionals and equipping them with the right knowledge, we are 
enabling them to identify hallmark signs of this despicable act for 
early intervention.
  This pilot program will test and examine the best practices needed 
for determining the protocol used for implementing human trafficking 
awareness within the medical community.
  As a nurse, I know that our country's medical professionals already 
play a significant role in caring for victims of human trafficking. 
This legislation will better prepare those on the front lines, so that 
they can identify and care for those being trafficked.
  Most Americans are unaware as to how prevalent and pervasive human 
trafficking is within our own borders, but it is time we acknowledge 
this fact and stand up against this heinous crime.
  Our medical base is in a position to help these victims break free, 
and I am proud to push forth legislation further empowering them. This 
legislation trains health care workers to recognize the hallmark signs 
of human trafficking, thus allowing professionals to intervene on the 
patient's behalf.
  I would like to thank my colleague, Congresswoman Debbie Wasserman 
Schultz from Florida, for helping me introduce H.R. 398 in Congress.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  1630

  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I think that we can all agree that human trafficking is 
an important problem that deserves Congress' attention, and that all of 
us support efforts to ensure that our health care workers are better 
prepared to identify and assist victims of human trafficking.
  H.R. 398, the Trafficking Awareness Training for Health Care Act of 
2015, would set up a grant, facilitated by the Department of Health and 
Human Services, to create and address best practices for health care 
providers to use in the field. The program would then test those 
practices in 10 pilot programs across the country.
  The goal of this legislation is laudable and would certainly take 
important steps to improve our ability to address the spread of human 
trafficking in our local communities. However, Mr. Speaker, I cannot 
support the process that brought this bill to the floor.
  This legislation has not gone through a subcommittee or full 
committee markup in the Energy and Commerce Committee, neither in the 
114th Congress nor the previous session. Going through the normal 
committee process would have allowed Members and staff to make 
substantive and technical changes to ensure that the Department of 
Health and Human Services is able to implement this legislation 
effectively. Members who serve on the Energy and Commerce Committee 
deserve the opportunity to deliberate on legislation within the 
committee's jurisdiction and offer amendments to strengthen the bills 
that we consider.
  Additionally, while this bill authorizes a new grant program, it does 
not authorize any additional appropriations for the Department to carry 
out this initiative. HHS may not be able to do this work within their 
limited existing resources. Advancing legislation, Mr. Speaker, that 
puts new requirements on the Federal Government without authorizing the 
funds to implement them is not a good precedent to set.
  So, Mr. Speaker, I cannot support new legislation that has not gone 
through the regular order process, but I will not object to considering 
H.R. 398 on suspension today and advancing the bill by voice vote.
  I reserve the balance of my time.
  Mrs. ELLMERS. Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from Florida, Ms. Debbie

[[Page 1254]]

Wasserman Schultz, who is the Democratic sponsor of the bill.
  Ms. WASSERMAN SCHULTZ. Mr. Speaker, I thank the gentleman from New 
Jersey and my colleague Congresswoman Ellmers from North Carolina and 
rise today in strong support of the Trafficking Awareness Training for 
Health Care Act of 2015, a bill on which I was honored to join as the 
Democratic lead with my colleague and good friend, the gentlewoman from 
North Carolina.
  I thank Congresswoman Ellmers for her leadership on this bill and her 
willingness to shine a light on the scourge of human trafficking.
  I was telling my staff the other day, Mr. Speaker, that it is a truly 
remarkable and sometimes too rare a thing in our Congress to find a 
Member who not only reaches across the aisle but who is also willing to 
work tirelessly to fight for what she believes in and has a staff 
willing to match that effort. It has been a pleasure working with you 
and your team on this legislation, as well as on my EARLY Act signed 
into law just a month ago, on which you served as the Republican lead 
on that legislation, and I look forward to what we may do together in 
the future.
  Mr. Speaker, after passing legislation that made human and sex 
trafficking a State crime in my home State of Florida, I knew that, 
while that was an important tool to combat traffickers, we were just 
scratching the surface.
  I joined Congresswoman Ellmers on this bill because, though there is 
still much that we need to learn about the way human trafficking works 
in the United States, we know enough to know that it is far too 
prevalent, it preys on the most vulnerable in our Nation, and 
addressing it requires a comprehensive approach that encompasses 
prevention, treatment, and going after criminals.
  We know that best guesses estimate there are 100,000 to 300,000 
American youth currently at risk of being trafficked in the United 
States. We know that those most likely to be targeted are low-income 
women, foster youth, younger girls, and girls and women with a history 
of abuse and estrangement from family. And we know that once a girl is 
sex-trafficked, she has a life expectancy of just 7 years, during which 
she will be raped on average by 6,000 different buyers.
  If the horror of human trafficking is not a problem that deserves a 
comprehensive response from all legal, social service, and medical 
sectors, then I don't know what is. Health care providers are often the 
first line of defense in these situations, sometimes being the only 
interaction with an outsider that a victim's trafficker may allow.
  The Trafficking Awareness Training for Health Care Act of 2015 
develops evidence-based best practices for, and training of, health 
care providers to be able to identify and properly respond to victims 
of trafficking, training that means when a girl 12 to 14 years old, the 
age range that is most at risk of being trafficked, when she is brought 
into a health care provider for a routine checkup by an older man who 
is not related to her, that a red flag goes off in a nurse's head or a 
health care provider's head.
  Best practices will mean when a woman comes into an ER for a broken 
arm but a doctor discovers bruises and scars indicating a pattern of 
abuse, that that doctor doesn't just simply treat her broken arm and 
send her home. And resource knowledge means doctors and nurses cannot 
only identify potential victims but can respond appropriately to ensure 
that victim will one day become a survivor.
  This bill joins several other trafficking bills being heard today on 
the House floor, including Representative Bass' bill to support youth 
most at risk for trafficking and Representative Noem's bill to 
encourage intra-agency and effective human trafficking intervention and 
prevention strategies.
  These two bills, as well as Representative Ellmers' and my bill, are 
all pieces of a larger puzzle, initiatives that, when put together, 
create a comprehensive and cross-sector response to human trafficking.
  We all stand up together today, regardless of political party, to say 
we do not want to raise our children in a world or a nation where a 
person can be sold as if she is property to be used by anyone to whom 
the trafficker offers her.
  I am proud to join my colleagues and Congresswoman Ellmers in the 
battle to eliminate human trafficking, for my daughters, who are 11 and 
15, for my constituents in south Florida, and for the betterment of our 
world. I might add, as a member of the House Committee on 
Appropriations, I can assure the gentleman that while I share and 
understand his concerns on the process, as far as the appropriations, 
we are going to pursue unobligated funds so that we can make sure that 
there are the resources available to make sure that this program is 
funded.
  Mrs. ELLMERS. Mr. Speaker, I yield myself such time as I may consume.
  I would like to say again to my good friend and colleague from 
Florida, thank you for putting forward this effort to work with us.
  To my colleague, Mr. Pallone, I, too, believe that we need to work 
together. So just know that my door is open, that we will continue to 
work on these issues together, and I am just so glad that in a 
bipartisan effort today we are all coming together to stand up for 
victims of human trafficking and again get them on a path to recovery.
  At this point, Mr. Speaker, I yield 3 minutes to the gentleman from 
New Jersey (Mr. Smith), my good friend, who has been a tireless and 
passionate advocate for women and families and children who are 
affected by human trafficking really long before many of us were even 
aware that it was an issue here in this country.
  Mr. SMITH of New Jersey. Mr. Speaker, I thank my good friend for 
yielding and thank her for her leadership, especially on this extremely 
important bill, H.R. 398, the Trafficking Awareness Training for Health 
Care Act of 2015.
  Mr. Speaker, this bill would direct grant money to the development of 
best practices for medical professionals so that they will know how to 
recognize trafficking victims and how to respond if a potential victim 
comes into their hospital or clinic.
  Mrs. Ellmers and I, and others, were inspired to do this bill by a 
Global Centurion report, in collaboration with the Charlotte Lozier 
Institute, that showed some 88 percent of domestic trafficking victims 
sought health care at some point during the time that they were being 
trafficked. That is absolutely amazing. These victimized women have 
come in contact with health care professionals, and then they leave and 
go out the door and nothing is done because the health care 
professional did not recognize the signs of human trafficking. They 
were in a clinic, hospital, or doctor's office when they were being 
trafficked, right back out the door to be trafficked again.
  With 99 percent of trafficking victims reporting serious health 
consequences of being trafficked and pimps eager to get their victims 
healthy for continued exploitation for profit, medical professionals 
are on the front lines of trafficking interventions. We must make sure 
that the health care professionals are equipped to assist in 
effectuating freedom for trafficking victims whenever possible. We must 
think carefully about protocols for how to report suspected victims to 
authority. We don't want to put her in further danger. We must 
strategize ways to ensure the victims receive the help that they need.
  Mr. Speaker, this is a very, very important bill, and I do hope my 
colleagues will support it. Again, I thank Mrs. Ellmers for her 
leadership on it.
  Mr. PALLONE. Mr. Speaker, I have no additional speakers at this time, 
so I yield back the balance of my time.
  Mrs. ELLMERS. Mr. Speaker, I yield myself such time as I may consume.
  In closing, I just want to say again how proud I am of our Congress 
and our colleagues on both sides of the aisle coming together to work 
on very, very important legislation dealing with those who have been 
trafficked. Human trafficking is a travesty, it is a heinous crime, and 
it is today's modern-day slavery.
  This is something that we must eradicate in this country. This is 
what the American people need for us to be a part of and work on.

[[Page 1255]]

  I am just so happy that we are dealing with an issue that is going to 
affect so many out there in this country who do not have a voice right 
now. We have the opportunity now to stand up for what is right. We have 
the opportunity to do what is right, and by us working together and 
having legislation that will be sponsored in the Senate, as many of us 
do, we feel very strongly that this will become law, and we will be 
able to enact it and help those victims so that they can be looking 
towards recovery and empowering their lives.
  Mr. Speaker, this is a very important day with 12 different bills 
that we are addressing. I am just so proud to be a part of it.
  Mr. Speaker, I yield back the balance of my time.
  Mr. UPTON. Mr. Speaker, I rise today in support of H.R. 398, the 
Trafficking Awareness Training for Health Care Act of 2015, introduced 
by Energy and Commerce Committee member Renee Ellmers of North 
Carolina.
  I wish this bill and others related to trafficking today were not 
necessary. But the sad reality is that according to the U.S. Department 
of Justice, human trafficking is the second fastest growing criminal 
industry--just behind drug trafficking. Adding to the urgency is that 
approximately half of all victims are children. It makes you sick.
  Human trafficking is a serious crime and a grave violation of human 
rights. Too often, this is a crime that goes unnoticed and it is one 
that is not well understood. It is simply too hard to imagine that a 
crime this horrendous could be happening right here on American soil, 
let alone in your own backyard. But it is. Not only does human 
trafficking occur in the United States, it is a lucrative business with 
billions of dollars in profits. It continues because victims are not 
easily identified and they are afraid. It happens in our own 
communities, because we are unaware. Today, we stand up and say no 
more.
  In order for victims of trafficking to break free, they need help. 
Health care professionals are one of the few groups to interact with 
trafficked women and girls and can be one source of help as twenty-
eight percent of trafficked women sought treatment from a health care 
professional while being held captive. Recent studies show that health 
care professionals are well positioned to be first responders if they 
have the training and skills to identify and help victims.
  The Trafficking Awareness Training for Health Care Act would provide 
for the development of evidence-based best practices to help health 
care providers to identify and assist victims of human trafficking. The 
bill requires HHS to award a grant to a medical or nursing school to 
develop best practices for medical personnel. These best practices will 
be tested in a pilot program conducted at Community Health Centers 
(CHCs) in each of the 10 administrative regions. The results of the 
pilot will be shared with the medical community for their 
consideration. This bill offers us an important opportunity to work 
with the medical community to improve awareness and ensure that human 
trafficking education and practice becomes a part of basic health care 
training.
  I thank Rep. Ellmers for her hard work this important piece of 
legislation and urge its passage.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from North Carolina (Mrs. Ellmers) that the House suspend 
the rules and pass the bill, H.R. 398.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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