[House Report 115-327]
[From the U.S. Government Publishing Office]


115th Congress    }                                     {       Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                     {      115-327

======================================================================



 
                SOAR TO HEALTH AND WELLNESS ACT OF 2017

                                _______
                                

 September 25, 2017.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Walden, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 767]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 767) to establish the Stop, Observe, Ask, and 
Respond to Health and Wellness Training pilot program to 
address human trafficking in the health care system, having 
considered the same, report favorably thereon with amendments 
and recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     3
Committee Action.................................................     3
Committee Votes..................................................     4
Oversight Findings and Recommendations...........................     4
New Budget Authority, Entitlement Authority, and Tax Expenditures     4
Congressional Budget Office Estimate.............................     4
Federal Mandates Statement.......................................     6
Statement of General Performance Goals and Objectives............     6
Duplication of Federal Programs..................................     6
Committee Cost Estimate..........................................     6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     6
Disclosure of Directed Rule Makings..............................     6
Advisory Committee Statement.....................................     6
Applicability to Legislative Branch..............................     7
Section-by-Section Analysis of the Legislation...................     7
Changes in Existing Law Made by the Bill, as Reported............     7

    The amendments are as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Stop, Observe, Ask, and Respond to 
Health and Wellness Act of 2017'' or the ``SOAR to Health and Wellness 
Act of 2017''.

SEC. 2. DEFINITIONS.

  In this Act:
          (1) Human trafficking.--The term ``human trafficking'' has 
        the meaning given the term ``severe forms of trafficking in 
        persons'' as defined in section 103 of the Trafficking Victims 
        Protection Act of 2000 (22 U.S.C. 7102).
          (2) Secretary.--The term ``Secretary'' means the Secretary of 
        Health and Human Services.

SEC. 3. PROGRAM ESTABLISHMENT.

  (a) In General.--The Secretary shall establish a program to be known 
as the Stop, Observe, Ask, and Respond to Health and Wellness Training 
Program or the SOAR to Health and Wellness Training Program (in this 
Act referred to as the ``Program'') to provide training to health care 
providers and other related providers, at all levels, on human 
trafficking in accordance with the purpose described in subsection (c).
  (b) Grants.--The Secretary may carry out the Program through the 
award of grants to health care sites and health care professional 
organizations that represent diversity in--
          (1) geography;
          (2) the demographics of the population served;
          (3) the predominant types of human trafficking cases; and
          (4) health care provider profiles.
  (c) Purpose.--The purpose of the Program shall be to train health 
care providers and other related providers to enable such providers 
to--
          (1) identify potential human trafficking victims;
          (2) implement proper protocols and procedures for working 
        with law enforcement to report, and facilitate communication 
        with, such victims, in accordance with all applicable Federal, 
        State, local, and tribal requirements, including legal 
        confidentiality requirements for patients and health care 
        providers;
          (3) implement proper protocols and procedures for referring 
        such victims to appropriate health care, social, or victims 
        service agencies or organizations;
          (4) provide such victims care that is--
                  (A) coordinated;
                  (B) victim centered;
                  (C) culturally relevant;
                  (D) comprehensive;
                  (E) evidence-based;
                  (F) gender responsive;
                  (G) age-appropriate, with a focus on care for youth; 
                and
                  (H) trauma-informed; and
          (5) consider the potential for integrating the training 
        described in paragraphs (1) through (4) with training programs, 
        in effect on the date of enactment of this Act, for victims of 
        domestic violence, dating violence, sexual assault, stalking, 
        child abuse, child neglect, child maltreatment, and child 
        sexual exploitation.
  (d) Functions.--
          (1) In general.--The functions of the Program shall include 
        the functions of the Stop, Observe, Ask, and Respond to Health 
        and Wellness Training program that was operating on the day 
        before the date of enactment of this Act and the authorized 
        initiatives described in paragraph (2).
          (2) Authorized initiatives.--The authorized initiatives of 
        the Program shall include--
                  (A) engaging stakeholders, including victims of human 
                trafficking and any Federal, State, local, or tribal 
                partners, to develop a flexible training module--
                          (i) for achieving the purpose described in 
                        subsection (c); and
                          (ii) that adapts to changing needs, settings, 
                        health care providers, and other related 
                        providers;
                  (B) providing technical assistance for health 
                education programs and health care professional 
                organizations to implement health care protocols, or 
                develop continuing education training materials, that 
                assist in achieving the purpose described in subsection 
                (c);
                  (C) facilitating the dissemination of best practices 
                and recommendations as the Secretary determines 
                appropriate; and
                  (D) developing a reliable methodology for collecting 
                data, and reporting such data, on the number of human 
                trafficking victims identified and served in health 
                care settings or other related provider settings.

SEC. 4. DATA COLLECTION AND REPORTING REQUIREMENTS.

  (a) Data Collection.--
          (1) In general.--During each of fiscal years 2018 through 
        2022, the Secretary shall collect data on each of the 
        following:
                  (A) The total number of grantees operating under the 
                Program.
                  (B) The total number of health care providers and 
                other related providers trained through the Program.
          (2) Initial report.--In addition to the data required to be 
        collected under paragraph (1), for purposes of the initial 
        report to be submitted under subsection (b), the Secretary 
        shall collect data on the total number of facilities and health 
        care professional organizations that were operating under, and 
        the total number of health care providers and other related 
        providers trained through, the Stop, Observe, Ask, and Respond 
        to Health and Wellness Training program that was operating 
        before the establishment under section 3(a) of the Program.
  (b) Reporting.--Not later than 90 days after the first day of each of 
fiscal years 2019 through 2023, the Secretary shall prepare and submit 
to Congress a report on the data collected under subsection (a).

SEC. 5. AUTHORIZATION OF APPROPRIATIONS.

  There is authorized to be appropriated to carry out this Act 
$4,000,000 for each of fiscal years 2018 through 2022.

    Amend the title so as to read:
    A bill to establish the Stop, Observe, Ask, and Respond to 
Health and Wellness Training Program to address human 
trafficking in the health care system.

                          PURPOSE AND SUMMARY

    H.R. 767 was introduced on January 31, 2017, by Rep. Steve 
Cohen (D-TN). The bill expands and further codifies the Stop, 
Observe, Ask, and Respond (SOAR) training program at the 
Administration for Children and Families, Office on Trafficking 
in Persons, which provides health care professionals training 
on how to identify and appropriately treat human trafficking 
victims.

                  BACKGROUND AND NEED FOR LEGISLATION

    According to the International Labour Organization (ILO), 
nearly 21 million people worldwide are victims of human 
trafficking, forced labor, or sexual exploitation. Many of 
these unidentified victims come into contact with health care 
professionals during their captivity. These professionals may 
be the only people that a victim has an opportunity to speak 
to, but may be ill-equipped to recognize victimization or to 
respond in an appropriate manner.
    The Stop, Observe, Ask, and Respond pilot initiative was 
originally launched in 2013 by the Administration for Children 
and Families, Office on Trafficking in Persons to enhance the 
health care system's response to trafficking. Training is 
currently a three-hour course delivered either in-person or 
through a webinar. Given that health professionals are in a 
unique position on the front lines to assist to human 
trafficking victims, enhancing SOAR program training to help 
them recognize the signs of exploitation and provide trauma-
informed, culturally-appropriate care will help increase 
opportunities to offer trafficked victims help and ultimately 
save lives.

                            COMMITTEE ACTION

    On May 17, 2017, the Subcommittee on Health held a hearing 
on H.R. 767. The hearing was entitled ``Examining Initiatives 
to Advance Public Health.'' The Subcommittee received testimony 
from:
           Kevin O'Connor, Assistant to the General 
        President, International Association of Fire Fighters;
           Cheryl D. Watson-Lowry, DDS; General 
        Dentist, American Dental Association;
           Martin S. Levine, DO, MPH, FACOFP, dist; 
        Interim Clinical Dean, Professor of Family and 
        Community Medicine, Touro College of Osteopathic 
        Medicine; and
           Jordan Greenbaum, MD; Medical Director, 
        Institute for Healthcare and Human Trafficking at 
        Children's Healthcare of Atlanta; Medical Director, 
        Global Initiative for Child Health and Well Being at 
        the International Centre for Missing and Exploited 
        Children.
    On June 29, 2017, the Subcommittee on Health met in open 
markup session and forwarded H.R. 767, as amended, to the full 
Committee by a voice vote. On July 27, 2017, the full Committee 
on Energy and Commerce met in open markup session and ordered 
H.R. 767, as amended, favorably reported to the House by a 
voice vote.

                            COMMITTEE VOTES

    Clause 3(b) of rule XIII requires the Committee to list the 
record votes on the motion to report legislation and amendments 
thereto. There were no record votes taken in connection with 
ordering H.R. 767 reported.

                 OVERSIGHT FINDINGS AND RECOMMENDATIONS

    Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of 
rule XIII, the Committee held a hearing and made findings that 
are reflected in this report.

   NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES

    Pursuant to clause 3(c)(2) of rule XIII, the Committee 
finds that H.R. 767 would result in no new or increased budget 
authority, entitlement authority, or tax expenditures or 
revenues.

                  CONGRESSIONAL BUDGET OFFICE ESTIMATE

    Pursuant to clause 3(c)(3) of rule XIII, the following is 
the cost estimate provided by the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.

                                     U.S. Congress,
                               Congressional Budget Office,
                                 Washington, DC, September 8, 2017.
Hon. Greg Walden,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 767, the SOAR to 
Health and Wellness Act of 2017.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Tia Caldwell.
            Sincerely,
                                                Keith Hall,
                                                          Director.
    Enclosure.

H.R. 767--SOAR to Health and Wellness Act of 2017

    Summary: H.R. 767 would require the Department of Health 
and Human Services (HHS) to establish a pilot program called 
Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness 
Training.
    CBO estimates that implementing the legislation would cost 
$17 million over the 2017-2022 period, assuming appropriation 
of the specified amounts. Enacting the bill would not affect 
direct spending or revenues; therefore, pay-as-you-go 
procedures do not apply.
    CBO estimates that enacting H.R. 767 would not increase net 
direct spending or on-budget deficits in any of the four 
consecutive 10-year periods beginning in 2028.
    H.R. 767 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would impose no costs on state, local, or tribal 
governments.
    Estimated cost to the Federal Government: The estimated 
budgetary effect of H.R. 767 is shown in the following table. 
The costs of this legislation fall within budget function 500 
(education, training, employment and social services).

----------------------------------------------------------------------------------------------------------------
                                                                   By fiscal year, in millions of dollars--
                                                            ----------------------------------------------------
                                                              2017   2018   2019   2020   2021   2022  2017-2022
----------------------------------------------------------------------------------------------------------------
                                 INCREASES IN SPENDING SUBJECT TO APPROPRIATION
 
Authorization Level........................................      0      4      4      4      4      4        20
Estimated Outlays..........................................      0      2      3      4      4      4        17
----------------------------------------------------------------------------------------------------------------

    Basis of estimate: For this estimate, CBO assumes that H.R. 
767 will be enacted near the start of 2018 and that the 
specified amounts will be appropriated for each year. The 
estimated outlays reflect historical spending patterns for 
similar programs administered by HHS.
    H.R. 767 would authorize the appropriation of $4 million 
for each of fiscal years 2018 through 2022 for HHS to provide 
grants for training health care providers on how to identify 
and care for the victims of human trafficking. The program 
would continue the functions of an existing pilot program, 
provide additional technical assistance, and seek to improve 
data collection.
    CBO estimates that implementing the legislation would cost 
$17 million over the 2018-2022 period, assuming appropriation 
of the specified amounts; the remainder would be spent in the 
years after 2022.
    Pay-As-You-Go considerations: None.
    Increase in long-term direct spending and deficits: CBO 
estimates that enacting H.R. 767 would not increase net direct 
spending or on-budget deficits in any of the four consecutive 
10-year periods beginning in 2028.
    Intergovernmental and private-sector impact: H.R. 767 
contains no intergovernmental or private-sector mandates as 
defined in UMRA.
    Estimate prepared by: Federal costs: Tia Caldwell; Impact 
on state, local, and tribal governments: Zach Byrum; Impact on 
the private sector: Amy Petz.
    Estimate approved by: H. Samuel Papenfuss, Deputy Assistant 
Director for Budget Analysis.

                       FEDERAL MANDATES STATEMENT

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

         STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to expand 
and further codify the SOAR program by allowing the program to 
provide grants to health care sites and health care 
professional organizations that support training to recognize 
and respond to human trafficking. The legislation also requires 
the program, in conjunction with stakeholders, to develop 
training modules, provide technical assistance to health 
education programs and professional organizations, help 
disseminate best practices, and develop data collection and 
reporting on the number of trafficking victims served in health 
care settings.

                    DUPLICATION OF FEDERAL PROGRAMS

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 767 is known to be duplicative of another Federal program, 
including any program that was included in a report to Congress 
pursuant to section 21 of Public Law 111-139 or the most recent 
Catalog of Federal Domestic Assistance.

                        COMMITTEE COST ESTIMATE

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

       EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 767 contains no earmarks, limited tax 
benefits, or limited tariff benefits.

                  DISCLOSURE OF DIRECTED RULE MAKINGS

    Pursuant to section 3(i) of H. Res. 5, the Committee finds 
that H.R. 767 contains no directed rule makings.

                      ADVISORY COMMITTEE STATEMENT

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  APPLICABILITY TO LEGISLATIVE BRANCH

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title

    Section 1 provides that the Act may be cited as the ``Stop, 
Observe, Ask, and Respond to Health and Wellness Act of 2017'' 
or the ``SOAR to Health and Wellness Act of 2017.''

Section 2. Definitions

    Section 2 provides the meanings for the terms ``human 
trafficking'' and ``Secretary.''

Section 3. Program establishment

    Section 3 authorizes the Secretary to establish a grant 
program known as the Stop, Observe, Ask, and Respond to Health 
and Wellness Training Program to provide training to health 
care providers on identifying potential human trafficking 
victims and implementing the proper procedures for providing 
appropriate care, working with law enforcement, and referring 
victims to the necessary health, social, or victims service 
agencies or organizations.

Section 4. Data collection and reporting requirements

    Section 4 requires the Secretary to collect data and report 
on the total number of grantees operating under the SOAR 
Program, and the total number of health care providers trained 
through the program.

Section 5. Authorization of appropriations

    Section 5 authorizes the appropriation of $4 million for 
each of fiscal years 2018 to 2022.

         CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

    This legislation does not amend any existing Federal 
statute.

                                  [all]