II 

117TH CONGRESS 

1ST SESSION S. 2655 

To provide funding for demonstration grants to support clinical training 

of health care providers to administer medical forensic examinations 

and treatments to survivors of interpersonal violence of all ages. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 5, 2021 

Ms. MURKOWSKI (for herself and Mr. HICKENLOOPER) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To provide funding for demonstration grants to support clinical training of health care providers to administer medical forensic examinations and treatments to survivors 

of interpersonal violence of all ages. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Ensuring Forensic 

5 Care for All Victims Act’’ or the ‘‘EFCA Act’’. 

6 SEC. 2. PURPOSE. 

7 It is the purpose of this Act to provide eligible entities 

8 funding through demonstration grants to develop trauma 


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1 informed standards of care through pilot programs that 

2 promote generalist forensic training using a module-based, 

3 conceptual learning program with competency-based ac4 tivities tailored to meet health care professional and first 

5 responder needs. 

6 SEC. 3. DEFINITIONS. 

7 In this Act: 

8 (1) COMMUNITY HEALTH AIDE; COMMUNITY

9 HEALTH PRACTITIONER.—The terms ‘‘community 

10 health aide’’ and ‘‘community health practitioner’’ 

11 have the meanings given such terms for purposes of 

12 section 119 of the Indian Health Care Improvement 

13 Act (25 U.S.C. 1616l). 

14 (2) FIRST RESPONDER.—The term ‘‘first re15 sponder’’ includes a firefighter, law enforcement offi16 cer, paramedic, emergency medical technician, or 

17 other individual (including an employee of a legally 

18 organized and recognized volunteer organization, 

19 whether compensated or not), who, in the course of 

20 his or her professional duties, responds to fire, med21 ical, hazardous material, or other similar emer22 gencies. 

23 (3) GENERALIST FORENSIC SERVICES.—The 

24 term ‘‘generalist forensic services’’ with respect to 

25 health care providers, means enabling such providers 


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1 to have expanded forensic knowledge and skills to 

2 ensure that individuals, families, and communities 

3 that have experienced interpersonal violence or trau4 ma are provided medical forensic assessment, evi5 dence collection, and documentation that aids in 

6 meeting the needs of patients as well as improves fu7 ture law enforcement investigation and prosecution, 

8 provides needed data for research to support re9 sponse and prevention of violence, and improves abil10 ity to adequately respond to patients who exhibit 

11 signs of victimization. 

12 (4) HEALTH CARE PROVIDER.—The term 

13 ‘‘health care provider’’ has the meaning given such 

14 term by the Secretary, and includes registered 

15 nurses, nurse practitioners, nurse midwives, clinical 

16 nurse specialists, physician assistants, and physi17 cians. 

18 (5) INDIAN TRIBES.—The terms ‘‘Indian Tribe’’ 

19 and ‘‘Tribal organization’’ shall have the meanings 

20 given such terms in section 4 of the Indian Self-De21 termination and Education Assistance Act (25 

22 U.S.C. 5304). The term ‘‘Urban Indian organiza23 tion’’ has the meaning given such term in section 4 

24 of the Indian Health Care Improvement Act (25 

25 U.S.C. 1603). 


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1 (6) INTERPERSONAL VIOLENCE.—The term 

2 ‘‘interpersonal violence’’ means any form of violence 

3 which is emotional and trauma inducing for victims, 

4 families of victims, perpetrators, and communities. 

5 (7) PROGRAM.—The term ‘‘program’’ means 

6 the program established under section 101. 

7 (8) SECRETARY.—The term ‘‘Secretary’’ means 

8 the Secretary of Health and Human Services. 

9 (9) STANDARD OF CARE.—The term ‘‘standard 

10 of care’’ means evaluation and treatment that is ac11 cepted by medical experts and reflected in peer-re12 viewed medical literature as the appropriate medical 

13 approach for a condition, symptoms, illness, or dis14 ease and that is widely used by health care profes15 sionals. 

16 (10) TRAUMA INFORMED CARE.—The term 

17 ‘‘trauma informed care’’ means care which trauma 

18 survivors receive that is culturally competent in ac19 cordance with professional standards of practice and 

20 accounting for patients’ experiences and preferences 

21 in order to eliminate or mitigate triggers that may 

22 cause re-traumatization of the patient. 


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1 TITLE I—ESTABLISHING A GEN2 ERALIST FORENSIC 

3 HEALTHCARE CLINICAL AND 

4 CONTINUING EDUCATION 

5 PILOT PROGRAM. 

6 SEC. 101. ESTABLISHMENT OF PROGRAM. 

7 (a) IN GENERAL.—The Secretary, in conjunction 

8 with Attorney General, shall establish a demonstration 

9 program to award grants to eligible partnered entities for 

10 the clinical training of health care providers, first respond11 ers, community health aides, community health practi12 tioners, and students and to enable such providers, first 

13 responders, community health aides, community health 

14 practitioners, and students to administer medical forensic 

15 examinations and treatments to survivors, perform med16 ical forensic assessments, evidence collection, and docu17 mentation that aids in meeting the needs of patients as 

18 well as improves future law enforcement investigation and 

19 prosecution, provides needed data for research to support 

20 response and prevention of interpersonal violence, and im21 proves the ability of providers, first responders, commu22 nity health aides, community health practitioners, and stu23 dents to adequately respond in difficult situations. 

24 (b) PURPOSE.—The purpose of the program is to en25 able each grant recipient to work with inter-professional 


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1 partners, including law enforcement, legal services, victims 

2 advocacy organizations, and others to expand access to 

3 generalist forensic services by providing providers with the 

4 clinical training necessary to establish and maintain com5 petency in general forensic services and to test the provi6 sions of such services at new facilities in expanded health 

7 care settings. 

8 SEC. 102. DEMONSTRATION GRANTS FOR COMPREHENSIVE 

9 FORENSIC TRAINING. 

10 (a) ESTABLISHMENT OF PROGRAM.—The Secretary 

11 shall establish a demonstration program to award grants 

12 to eligible partnered entities for the clinical training of 

13 health care providers to administer medical forensic ex14 aminations and treatments to survivors of interpersonal 

15 violence of all ages. 

16 (b) PURPOSE.—The purpose of the demonstration 

17 program is to develop training and curriculum to provide 

18 health care providers with the skills to provide competent 

19 medical forensic assessment and care to individuals, fami20 lies, and communities that have experienced violence or 

21 trauma and be available to collaborate with members of 

22 an inter-professional forensic team. 

23 (c) TERM.—Grants under this section shall be for a 

24 term of 5 years. 


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1 (d) ELIGIBLE ENTITIES.—To be eligible to receive a 

2 grant under this section, an entity shall— 

3 (1) be— 

4 (A) an institute of higher education; or 

5 (B) Indian Tribes or Tribal organizations; 

6 and 

7 (2) submit to the Secretary an application at 

8 such time, in such manner, and containing such in9 formation as the Secretary may require. 

10 (e) GRANT AMOUNT.—Each grant awarded under 

11 this section shall be in an amount that does not exceed 

12 $400,000 per year. A grant recipient may carry over funds 

13 from one fiscal year to the next without obtaining approval 

14 from the Secretary. 

15 (f) AUTHORIZATION OF APPROPRIATIONS.— 

16 (1) IN GENERAL.—There is authorized to be 

17 appropriated to carry out this section $11,000,000 

18 for each of fiscal years 2022 through 2026. 

19 (2) SET-ASIDE.—Of the amount appropriated 

20 under this subsection for a fiscal year, the Secretary 

21 shall reserve 10 percent of such amount for purposes 

22 of making grants to entities that are affiliated with 

23 Indian Tribes or Tribal organizations, or Urban In24 dian organizations. Amounts so reserved may be 

25 used to support referrals and the delivery of emerVerDate Sep 11 2014 18:07 Aug 12, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2655.IS S2655

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1 gency first aid, culturally competent support, and fo2 rensic evidence collection training. 

3 TITLE II—TECHNICAL ASSIST4 ANCE GRANTS AND LEARN5 ING COLLECTIVES 

6 SEC. 201. TECHNICAL ASSISTANCE GRANTS AND LEARNING 

7 COLLECTIVES. 

8 Part B of title VIII of the Public Health Service Act 

9 (42 U.S.C. 296j et seq.) is amended by adding at the end 

10 the following: 

11 ‘‘SEC. 812. TECHNICAL ASSISTANCE CENTER AND RE12 GIONAL LEARNING COLLECTIVES. 

13 ‘‘(a) IN GENERAL.—The Secretary shall establish a 

14 State and forensic provider technical resource center to 

15 provide technical assistance to health care providers and 

16 community health aides to increase the quality of, and ac17 cess to, generalist forensic services by entering into con18 tracts with national experts (such as the Academy of Fo19 rensic Nursing and others). 

20 ‘‘(b) REGIONAL LEARNING COLLECTIVES.—The Sec21 retary shall convene State and hospital regional learning 

22 collectives to assist health care providers and States in 

23 sharing best practices, discussing practices, and improving 

24 the quality of, and access to, generalist forensic services. 


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1 ‘‘(c) REPOSITORY.—The Secretary shall establish and 

2 maintain a secure Internet-based data repository to serve 

3 as an online learning collective for State and entity col4 laborations. An entity receiving a grant under section 102 

5 may use such repository for— 

6 ‘‘(1) technical assistance; and 

7 ‘‘(2) best practice sharing. 

8 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

9 is authorized to be appropriated to carry out this section 

10 $2,000,000 for each of fiscal years 2022 through 2026.’’. 

11 TITLE III—NATIONAL REPORT 

12 ON THE NEED FOR GENER13 ALIST FORENSIC SERVICES IN 

14 OUR NATION’S HEALTH SYS15 TEM 

16 SEC. 301. NATIONAL REPORT. 

17 Not later than 1 year after the date of enactment 

18 of this Act, and annually thereafter, the Office for Victims 

19 of Crime of the Department of Justice, the Centers for 

20 Disease Control and Prevention, the Health Resources 

21 and Services Administration, the Indian Health Service, 

22 the Office on Women’s Health of the Department of 

23 Health and Human Services, and the Office of Violence 

24 Against Women of the Department of Justice (hereafter 

25 referred to in this section collectively as the ‘‘Agencies’’), 


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1 shall submit to the Secretary a report on the need 

2 throughout the United States and territories for increased 

3 access to generalist medical forensic services, evidence col4 lection, and documentation that aids in meeting the needs 

5 of health care patients as well as improves future law en6 forcement investigation and prosecution, the need for data 

7 for research to support response and prevention of inter8 personal violence, and improved ability of health care pro9 viders to adequately respond to patients who exhibit signs 

10 of victimization. 

Æ 


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