[House Report 116-586]
[From the U.S. Government Publishing Office]


116th Congress }                                            { Report
                        HOUSE OF REPRESENTATIVES
 2d Session    }                                            { 116-586

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



 
          BIPARTISAN SOLUTION TO CYCLICAL VIOLENCE ACT OF 2020

                                _______
                                

 November 16, 2020.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

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

                              R E P O R T

                        [To accompany H.R. 5855]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 5855) to amend the Public Health Service Act to 
establish a grant program supporting trauma center violence 
intervention and violence prevention programs, and for other 
purposes, having considered the same, reports favorably thereon 
without amendment and recommends that the bill do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary..............................................1
 II. Background and Need for the Legislation..........................2
III. Committee Hearings...............................................2
 IV. Committee Consideration..........................................3
  V. Committee Votes..................................................3
 VI. Oversight Findings...............................................3
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures3
VIII.Federal Mandates Statement.......................................4

 IX. Statement of General Performance Goals and Objectives............4
  X. Duplication of Federal Programs..................................4
 XI. Committee Cost Estimate..........................................4
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......4
XIII.Advisory Committee Statement.....................................4

XIV. Applicability to Legislative Branch..............................4
 XV. Section-by-Section Analysis of the Legislation...................4
XVI. Changes in Existing Law Made by the Bill, as Reported............5

                         I. Purpose and Summary

    H.R. 5855, the ``Bipartisan Solution to Cyclical Violence 
Act of 2020'', was introduced by Representatives C.A. Dutch 
Ruppersberger (D-MD) and Adam Kinzinger (R-IL). This bill would 
create a grant program at the Department of Health and Human 
Services (HHS) for trauma centers to establish or expand 
violence intervention and violence prevention programs. Funds 
made available under the bill would also be provided to conduct 
research to reduce the incidence of reinjury and 
reincarceration caused by certain types intentional violent 
trauma.

                II. Background and Need for Legislation

    Tragically, homicide is the leading cause of death for 
Black males ages 1 to 24 years old and the second leading cause 
of death in Hispanic males ages 1 to 24 years old.\1\ 
Regardless of race, it is estimated that among those who 
survive a single violent trauma up to 45 percent will 
experience a second violent trauma.\2\ Once caught in this 
cycle of violence, these individuals have a 20 percent higher 
five-year mortality rate than those not in the cycle.\3\
---------------------------------------------------------------------------
    \1\Richard G. Rogers, et al., Racial/Ethnic Differences in Early-
Life Mortality in the United States, Biodemography and Social Biology 
(Oct. 16, 2017).
    \2\Centers for Disease Control and Prevention, Key Injury and 
Violence Data (www.cdc.gov/injury/wisqars/overview/key_data.html).
    \3\Bethany Strong, et al., Trauma Recidivism Predicts Long-term 
Mortality: Missed Opportunities for Prevention (Retrospective Cohort 
Study), Annal of Surgery (May 2017).
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    Hospital-based violence intervention programs are 
multidisciplinary programs that identify patients at risk of 
repeat violent injury and connect them with hospital- and 
community-based resources that help address underlying risk 
factors for violence.\4\ Data has shown that the impact of a 
violence intervention program is greatest when victims of a 
violent crime are engaged while still in the hospital 
recovering from their injuries.\5\ Hospital-based violence 
intervention programs provide intensive case management to 
individuals who have experienced at least one violent trauma 
and have been shown to successfully reduce injury 
recidivism.6}7}8
---------------------------------------------------------------------------
    \4\Violence intervention programs: A primer for developing a 
comprehensive program for trauma centers, Bulletin of the American 
College of Surgeons (Oct. 4, 2017) (www.bulletin.facs.org/2017/10/
violence-intervention-programs-a-primer-for-developing-a-comprehensive-
program-for-trauma-centers/).
    \5\Carnell Cooper, M.D., et al., Repeat victims of violence: Report 
of a large concurrent case-control study, Archives of Surgery (July 
2000).
    \6\Teresa M. Bell, et al., Long-term evaluation of a hospital-based 
violence intervention program using a regional health information 
exchange, The Journal of Trauma and Acute Care Surgery (January 2018).
    \7\Erik J. Kramer, et al., Violent reinjury risk assessment 
instrument (VRRAI) for hospital-based violence intervention programs, 
Journal of Surgical Research (May 11, 2017).
    \8\See note 5.
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    H.R. 5855 would develop a grant program at HHS to establish 
or expand violence intervention or prevention programs at 
trauma centers or eligible nonprofit entities in communities 
with at least 100 incidents of intentional violent trauma a 
year. Such grants should be awarded with a priority given to 
applicants serving populations experiencing a high level of 
intentional violent trauma. The Secretary of HHS shall 
encourage entities in Health Professional Shortage Areas to 
apply for the program. The bill also requires recipients of 
these grants to report any significant findings to the 
Secretary, for the purposes of creating a website in order to 
document best practices for intentional violent trauma 
prevention.

                        III. Committee Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop or 
consider H.R. 5855:
    The Subcommittee on Health held a legislative hearing on 
June 30, 2020, to consider H.R. 5855. The hearing was entitled, 
``High Anxiety and Stress: Legislation to Improve Mental Health 
During Crisis.'' The Subcommittee received testimony from the 
following witnesses:
           The Honorable Patrick J. Kennedy, Founder of 
        the Kennedy Forum and former Member of Congress
           Arthur C. Evans, Jr. Ph.D., Chief Executive 
        Officer, American Psychological Association
           Jeffrey L. Geller, M.D., M.P.H., President, 
        American Psychiatric Association
           Arriana Gross, National Youth Advisory Board 
        Member, Sandy Hook Promise Students Against Violence 
        Everywhere (SAVE) Promise Club

                      IV. Committee Consideration

    Representatives Ruppersberger and Kinzinger introduced H.R. 
5855 on February 11, 2020, and the bill was referred to the 
Committee on Energy and Commerce. H.R. 5855 was then referred 
to the Subcommittee on Health on February 12, 2020. A 
legislative hearing was held on the bill on June 30, 2020.
    On September 9, 2020, H.R. 5855 was discharged from further 
consideration by the Subcommittee on Health as it was called up 
for consideration by the full Committee on Energy and Commerce. 
The full Committee met in virtual open markup session on 
September 9, 2020, pursuant to notice, to consider H.R. 5855. 
No amendments were offered during consideration of H.R. 5855. 
Upon conclusion of consideration of the bill, the full 
Committee agreed to a motion on final passage offered by Mr. 
Pallone, Chairman of the committee, to order H.R. 5855 reported 
favorably to the House, without amendment, by a voice vote, a 
quorum being present.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
5855, including on the motion for final passage of the bill.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. 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.

       IX. 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 
establish a grant program for specified trauma centers to 
establish or expand intervention or prevention programs related 
to certain types of intentional violent trauma.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 5855 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.

                      XI. 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.

    XII. Earmarks, 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. 5855 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

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

                XIV. 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.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``Bipartisan Solution to Cyclical Violence Act of 2020''.

Sec. 2. Grant program supporting trauma center violence intervention 
        and violence prevention programs

    Section 2 amends the Public Health Service Act by adding a 
new section that authorizes the Secretary of HHS to award 
grants to expand or establish violence intervention programs 
designed to reduce the incidence of reinjury and 
reincarceration caused by certain intentional violent trauma. 
Such awards shall be for a three-year grant period and shall be 
between $250,000 and $500,000 each. The first award must be 
made by the Secretary within nine months of enactment.
    Eligible entities include State-designated trauma centers, 
trauma centers verified by the American College of Surgeons, or 
nonprofit entities serving communities with at least 100 
incidents of intentional violent trauma annually and seeking to 
conduct a violence intervention program with an eligible trauma 
center. Grant recipients shall be geographically diverse, and 
priority shall be given to entities that serve one or more 
communities with high absolute numbers or high rates of 
intentional violent trauma. The Secretary shall encourage 
entities from within a health professional shortage area to 
apply for such grants.
    Grant recipients shall report to the Secretary any 
significant findings of the program. In turn, the Secretary 
shall develop and post best practices for intentional violent 
trauma prevention on an HHS website, as well as disseminate 
best practices to stakeholders as appropriate. The Secretary is 
also required to submit to Congress a report within six years 
of enactment focused on any findings resulting from the reports 
of grant recipients, best practices developed by the Secretary, 
and recommendations for legislative actions relating to 
intentional violent trauma prevention that the Secretary 
determines is appropriate.
    To carry out the program, section 2 authorizes to be 
appropriated $10,000,000 for the period of fiscal years 2020 
through 2023.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT



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TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

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PART P--ADDITIONAL PROGRAMS

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SEC. 399V-7. GRANT PROGRAM SUPPORTING TRAUMA CENTER VIOLENCE 
                    INTERVENTION AND VIOLENCE PREVENTION PROGRAMS.

  (a) Authority Established.--
          (1) In general.--The Secretary shall award grants to 
        eligible entities to establish or expand violence 
        intervention or prevention programs for services and 
        research designed to reduce the incidence of reinjury 
        and reincarceration caused by intentional violent 
        trauma, excluding intimate partner violence.
          (2) First award.--Not later than 9 months after the 
        date of enactment of this section, the Secretary shall 
        make the first award under paragraph (1).
          (3) Grant duration.--Each grant awarded under 
        paragraph (1) shall be for a period of three years.
          (4) Grant amount.--The total amount of each grant 
        awarded under paragraph (1) for the 3-year grant period 
        shall be not less than $250,000 and not more than 
        $500,000.
          (5) Supplement not supplant.--A grant awarded under 
        paragraph (1) to an eligible entity with an existing 
        program described in paragraph (1) shall be used to 
        supplement, and not supplant, any other funds provided 
        to such entity for such program.
  (b) Eligible Entities.--To be eligible to receive a grant 
under subsection (a)(1), an entity shall--
          (1) either be--
                  (A) a State-designated trauma center, or a 
                trauma center verified by the American College 
                of Surgeons, that conducts or seeks to conduct 
                a violence intervention or violence prevention 
                program; or
                  (B) a nonprofit entity that conducts or seeks 
                to conduct a program described in subparagraph 
                (A) in cooperation with a trauma center 
                described in such subparagraph;
          (2) serve a community in which at least 100 incidents 
        of intentional violent trauma occur annually; and
          (3) submit to the Secretary an application at such 
        time, in such manner, and containing such information 
        as the Secretary may require.
  (c) Selection of Grant Recipients.--
          (1) Geographic diversity.--In selecting grant 
        recipients under subsection (a)(1), the Secretary shall 
        ensure that collectively grantees represent a diversity 
        of geographic areas.
          (2) Priority.--In selecting grant recipients under 
        subsection (a)(1), the Secretary shall prioritize 
        applicants that serve one or more communities with high 
        absolute numbers or high rates of intentional violent 
        trauma.
          (3) Health professional shortage areas.--
                  (A) Encouragement.--The Secretary shall 
                encourage entities described in paragraphs (1) 
                and (2) that are located in or serve a health 
                professional shortage area to apply for grants 
                under subsection (a)(1).
                  (B) Definition.--In subparagraph (A), the 
                term ``health professional shortage area'' 
                means a health professional shortage area 
                designated under section 332.
  (d) Reports.--
          (1) Reports to secretary.--
                  (A) In general.--An entity that receives a 
                grant under subsection (a)(1) shall submit 
                reports on the use of the grant funds to the 
                Secretary, including progress reports, as 
                required by the Secretary. Such reports shall 
                include--
                          (i) any findings of the program 
                        established, or expanded, by the entity 
                        through the grant; and
                          (ii) if applicable, the manner in 
                        which the entity has incorporated such 
                        findings in the violence intervention 
                        or violence prevention program 
                        conducted by such entity.
                  (B) Option for joint report.--To the extent 
                feasible and appropriate, an entity that 
                receives a grant under subsection (a)(1) may 
                elect to coordinate with one or more other 
                entities that have received such a grant to 
                submit a joint report that meets the 
                requirements of subparagraph (A).
          (2) Report to congress.--Not later than six years 
        after the date of enactment of the Bipartisan Solution 
        to Cyclical Violence Act of 2020, the Secretary shall 
        submit to Congress a report--
                  (A) on any findings resulting from reports 
                submitted to the Secretary under paragraph (1);
                  (B) on best practices developed by the 
                Secretary under subsection (e); and
                  (C) with recommendations for legislative 
                action relating to intentional violent trauma 
                prevention that the Secretary determines 
                appropriate.
  (e) Best Practices.--Not later than six years after the date 
of enactment of the Bipartisan Solution to Cyclical Violence 
Act of 2020, the Secretary shall--
          (1) develop, and post on a public website of the 
        Department of Health and Human Services, best practices 
        for intentional violent trauma prevention, based on any 
        findings reported to the Secretary under subsection 
        (d)(1); and
          (2) disseminate such best practices to stakeholders, 
        as determined appropriate by the Secretary.
  (f) Authorization of Appropriations.--To carry out this 
section, there is authorized to be appropriated $10,000,000 for 
the period of fiscal years 2020 through 2023.

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