I 

112TH CONGRESS 

1ST SESSION H. R. 2704 

To reduce the spread of sexually transmitted infections in correctional 

facilities, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 29, 2011 

Ms. LEE of California introduced the following bill; which was referred to the 

Committee on the Judiciary, and in addition to the Committee on Energy 

and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To reduce the spread of sexually transmitted infections in 

correctional facilities, and for other purposes. 

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 ‘‘Justice for the Unpro5 tected Against Sexually Transmitted Infections among the 

6 Confined and Exposed Act’’ or the ‘‘JUSTICE Act’’. 

7 SEC. 2. FINDINGS. 

8 The Congress makes the following findings: 


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1 (1) According to the Bureau of Justice Statis2 tics (BJS), 2,292,133 persons were incarcerated in 

3 the United States as of the end of 2009. Between 

4 1998 and 2008, the number of persons incarcerated 

5 in Federal or State correctional facilities increased 

6 by an average of 2.4 percent per year. One in every 

7 32 United States residents was on probation, in jail 

8 or prison, or on parole at the end of 2009. 

9 (2) As of 2009, 66.8 percent of incarcerated 

10 persons were racial or ethnic minorities. Based on 

11 current incarceration rates, BJS estimates that Afri12 can-American males are 6 times more likely to be 

13 held in custody than White males, while Hispanic 

14 males are a little more than 2 times more likely to 

15 be held in custody. Across all age categories, Afri16 can-American males were incarcerated at higher 

17 rates than Hispanic or White males. 

18 (3) There is a disproportionately high rate of 

19 HIV/AIDS among incarcerated persons, especially 

20 among minorities. Approximately 25 percent of the 

21 HIV-positive population of the United States passes 

22 through correctional facilities each year. BJS has 

23 determined that the rate of confirmed AIDS cases is 

24 2.4 times higher among incarcerated persons than in 

25 the general population. Minorities account for the 


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1 majority of AIDS-related deaths among incarcerated 

2 persons, with African-American incarcerated persons 

3 2.8 times more likely than White incarcerated per4 sons and 1.4 times more likely than Hispanic incar5 cerated persons to die from AIDS-related causes. 

6 Nearly two-thirds of AIDS-related deaths are among 

7 Black, non-Hispanic males. 

8 (4) Studies suggest that other sexually trans9 mitted infections (STIs), such as gonorrhea, 

10 chlamydia, syphilis, genital herpes, viral hepatitis, 

11 and human papillomavirus, also exist at a higher 

12 rate among incarcerated persons than in the general 

13 population. For instance, researchers have estimated 

14 that the rate of hepatitis C (HCV) infection among 

15 incarcerated persons is somewhere between 8 and 20 

16 times higher than that of the general population. 

17 (5) Correctional facilities lack a uniform system 

18 of STI testing and reporting. Establishing a uniform 

19 data collection system would assist in developing and 

20 targeting counseling and treatment programs for in21 carcerated persons. Better developed and targeted 

22 programs may reduce the spread of STIs. 

23 (6) Although Congress has acted to reduce the 

24 spread of sexual violence in correctional facilities by 

25 enacting the National Prison Rape Elimination Act 


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1 (PREA) of 2003, BJS reported that approximately 

2 4.4 percent of incarcerated persons in prisons and 

3 3.1 percent of persons in jail reported experiencing 

4 one or more incidents of sexual victimization by an5 other incarcerated person or correctional facility 

6 staff in the previous year. 

7 (7) Approximately 95 percent of all incarcer8 ated persons eventually return to society. According 

9 to one study, every year approximately 100,000 per10 sons infected with both HIV and HCV are released 

11 from correctional facilities. These individuals com12 prise approximately 50 percent of all persons with 

13 both infections in the United States. 

14 (8) According to the Centers for Disease Con15 trol and Prevention (CDC), latex condoms, when 

16 used consistently and correctly, are highly effective 

17 in preventing the transmission of HIV. Latex 

18 condoms also reduce the risk of other STIs. Despite 

19 the effectiveness of condoms in reducing the spread 

20 of STIs, the Bureau of Prisons does not recommend 

21 their use in correctional facilities. 

22 (9) The distribution of condoms in correctional 

23 facilities is currently legal in certain parts of the 

24 United States and the world. The States of Vermont 

25 and Mississippi and the District of Columbia allow 


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1 condom distribution programs in their correctional 

2 facilities. The cities of New York, San Francisco, 

3 Los Angeles, Washington DC, and Philadelphia also 

4 allow condom distribution in their correctional facili5 ties. However, these States and cities operate fewer 

6 than 1 percent of all correctional facilities. 

7 (10) A 2007 report by the Massachusetts Gen8 eral Hospital Division of Infectious Diseases and the 

9 University of California, San Francisco, found that 

10 the proportion of European prison systems allowing 

11 condoms rose from 53 percent in 1989 to 81 percent 

12 in 1997. The same report also found that no prison 

13 system allowing the distribution of condoms had re14 versed their decision, and no prison system reported 

15 an increase in sexual activity among incarcerated 

16 persons as a result of a decision to allow condom 

17 distribution. 

18 (11) In 2000 and 2001, researchers surveyed 

19 300 incarcerated persons and 100 correctional offi20 cers at the Central Detention Facility, a correctional 

21 facility operated by the District of Columbia at 

22 which condoms are available. Researchers found that 

23 both incarcerated persons and correctional officers 

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1 more, the researchers determined that the program 

2 had not caused any major security infractions. In 

3 Canada, the Expert Committee on AIDS and Pris4 ons surveyed more than 400 correctional officers in 

5 the Federal prison system of Canada in 1995 and 

6 reported that 82 percent of those responding indi7 cated that the availability of condoms had created no 

8 problems at their facility. 

9 (12) The American Public Health Association, 

10 the United Nations Joint Program on HIV/AIDS, 

11 and the World Health Organization have endorsed 

12 the effectiveness of condom distribution programs in 

13 correctional facilities. 

14 (13) Many correctional facilities in the United 

15 States do not provide comprehensive testing and 

16 treatment programs to reduce the spread of STIs. 

17 According to BJS surveys from 2005, only 996 of 

18 the 1,821 Federal and State correctional facilities 

19 (i.e. 54.7 percent) provided HIV/AIDS counseling 

20 programs. 

21 (14) Individuals who are enrolled in Medicaid 

22 prior to incarceration face a suspension of their ben23 efits upon incarceration, and in some States a termi24 nation of their Medicaid eligibility. The Federal Gov25 ernment encourages States to automatically re-enroll 


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1 incarcerated persons on Medicaid upon their release 

2 from a correctional facility, unless the State reaches 

3 a determination that the individual is no longer eligi4 ble for reasons other than their prior incarceration. 

5 (15) Formerly incarcerated individuals who are 

6 newly released from correctional facilities often face 

7 delays in the resumption of their Medicaid benefits 

8 which may exacerbate any health issues which they 

9 face. 

10 (16) Incarcerated individuals living with HIV/ 

11 AIDS who are eligible for Medicaid would benefit 

12 from prompt and automatic enrollment upon their 

13 release in order to ensure their continued ability to 

14 access health services, including antiretroviral treat15 ment. 

16 SEC. 3. AUTHORITY TO ALLOW COMMUNITY ORGANIZA17 TIONS TO PROVIDE STI COUNSELING, STI 

18 PREVENTION EDUCATION, AND SEXUAL BAR19 RIER PROTECTION DEVICES IN FEDERAL 

20 CORRECTIONAL FACILITIES. 

21 (a) DIRECTIVE TO ATTORNEY GENERAL.—Not later 

22 than 30 days after the date of enactment of this Act, the 

23 Attorney General shall direct the Bureau of Prisons to 

24 allow community organizations to distribute sexual barrier 

25 protection devices and to engage in STI counseling and 


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1 STI prevention education in Federal correctional facilities. 

2 These activities shall be subject to all relevant Federal 

3 laws and regulations which govern visitation in correc4 tional facilities. 

5 (b) INFORMATION REQUIREMENT.—Any community 

6 organization permitted to distribute sexual barrier protec7 tion devices under subsection (a) must ensure that the 

8 persons to whom the devices are distributed are informed 

9 about the proper use and disposal of sexual barrier protec10 tion devices in accordance with established public health 

11 practices. Any community organization conducting STI 

12 counseling or STI prevention education under subsection 

13 (a) must offer comprehensive sexuality education. 

14 (c) POSSESSION OF DEVICE PROTECTED.—No Fed15 eral correctional facility may, because of the possession or 

16 use of a sexual barrier protection device— 

17 (1) take adverse action against an incarcerated 

18 person; or 

19 (2) consider possession or use as evidence of 

20 prohibited activity for the purpose of any Federal 

21 correctional facility administrative proceeding. 

22 (d) IMPLEMENTATION.—The Attorney General and 

23 Bureau of Prisons shall implement this section according 

24 to established public health practices in a manner that 


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1 protects the health, safety, and privacy of incarcerated 

2 persons and of correctional facility staff. 

3 SEC. 4. SENSE OF CONGRESS REGARDING DISTRIBUTION 

4 OF SEXUAL BARRIER PROTECTION DEVICES 

5 IN STATE PRISON SYSTEMS. 

6 It is the sense of Congress that States should allow 

7 for the legal distribution of sexual barrier protection de8 vices in State correctional facilities to reduce the preva9 lence and spread of STIs in those facilities. 

10 SEC. 5. AUTOMATIC REINSTATEMENT OF MEDICAID BENE11 FITS. 

12 (a) IN GENERAL.—Section 1902(e) of the Social Se13 curity Act (42 U.S.C. 1396a(e)) is amended by adding at 

14 the end the following: 

15 ‘‘(15) ENROLLMENT OF EX-OFFENDERS.— 

16 ‘‘(A) AUTOMATIC ENROLLMENT OR REIN17 STATEMENT.— 

18 ‘‘(i) IN GENERAL.—The State plan 

19 shall provide for the automatic enrollment 

20 or reinstatement of enrollment of an eligi21 ble individual— 

22 ‘‘(I) if such individual is sched23 uled to be released from a public insti24 tution due to the completion of senVerDate Mar 15 2010 04:22 Jul 30, 2011 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2704.IH H2704

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1 tence, not less than 30 days prior to 

2 the scheduled date of the release; and 

3 ‘‘(II) if such individual is to be 

4 released from a public institution on 

5 parole or on probation, as soon as 

6 possible after the date on which the 

7 determination to release such indi8 vidual was made, and before the date 

9 such individual is released. 

10 ‘‘(ii) EXCEPTION.—If a State makes a 

11 determination that an individual is not eli12 gible to be enrolled under the State plan— 

13 ‘‘(I) on or before the date by 

14 which the individual would be enrolled 

15 under clause (i), such clause shall not 

16 apply to such individual; or 

17 ‘‘(II) after such date, the State 

18 may terminate the enrollment of such 

19 individual. 

20 ‘‘(B) RELATIONSHIP OF ENROLLMENT TO

21 PAYMENT FOR SERVICES.— 

22 ‘‘(i) IN GENERAL.—Subject to sub23 paragraph (A)(ii), an eligible individual 

24 who is enrolled, or whose enrollment is re25 instated, under subparagraph (A) shall be 


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1 eligible for medical assistance that is pro2 vided after the date that the eligible indi3 vidual is released from the public institu4 tion 

5 ‘‘(ii) RELATIONSHIP TO PAYMENT

6 PROHIBITION FOR INMATES.—No provision 

7 of this paragraph may be construed to per8 mit payment for care or services for which 

9 payment is excluded under subparagraph 

10 (A), following paragraph (29), in section 

11 1905(a). 

12 ‘‘(C) TREATMENT OF CONTINUOUS ELIGI13 BILITY.— 

14 ‘‘(i) SUSPENSION FOR INMATES.—Any 

15 period of continuous eligibility under this 

16 title shall be suspended on the date an in17 dividual enrolled under this title becomes 

18 an inmate of a public institution (except as 

19 a patient of a medical institution). 

20 ‘‘(ii) DETERMINATION OF REMAINING

21 PERIOD.—Notwithstanding any changes to 

22 State law related to continuous eligibility 

23 during the time that an individual is an in24 mate of a public institution (except as a 

25 patient of a medical institution), subject to 


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1 clause (iii), with respect to an eligible indi2 vidual who was subject to a suspension 

3 under subclause (I), on the date that such 

4 individual is released from a public institu5 tion the suspension of continuous eligibility 

6 under such subclause shall be lifted for a 

7 period that is equal to the time remaining 

8 in the period of continuous eligibility for 

9 such individual on the date that such pe10 riod was suspended under such subclause. 

11 ‘‘(iii) EXCEPTION.—If a State makes 

12 a determination that an individual is not 

13 eligible to be enrolled under the State 

14 plan— 

15 ‘‘(I) on or before the date that 

16 the suspension of continuous eligibility 

17 is lifted under clause (ii), such clause 

18 shall not apply to such individual; or 

19 ‘‘(II) after such date, the State 

20 may terminate the enrollment of such 

21 individual. 

22 ‘‘(D) AUTOMATIC ENROLLMENT OR REIN23 STATEMENT OF ENROLLMENT DEFINED.—For 

24 purposes of this paragraph, the term ‘automatic 

25 enrollment or reinstatement of enrollment’ 


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1 means that the State determines eligibility for 

2 medical assistance under the State plan without 

3 a program application from, or on behalf of, the 

4 eligible individual, but an individual can only be 

5 automatically enrolled in the State Medicaid 

6 plan if the individual affirmatively consents to 

7 being enrolled through affirmation in writing, 

8 by telephone, orally, through electronic signa9 ture, or through any other means specified by 

10 the Secretary. 

11 ‘‘(E) ELIGIBLE INDIVIDUAL DEFINED.— 

12 For purposes of this paragraph, the term ‘eligi13 ble individual’ means an individual who is an 

14 inmate of a public institution (except as a pa15 tient in a medical institution)— 

16 ‘‘(i) who was enrolled under the State 

17 plan for medical assistance immediately be18 fore becoming an inmate of such an insti19 tution; or 

20 ‘‘(ii) is diagnosed with human im21 munodeficiency virus.’’. 

22 (b) SUPPLEMENTAL FUNDING FOR STATE IMPLE23 MENTATION OF AUTOMATIC REINSTATEMENT OF MED24 ICAID BENEFITS.— 


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1 (1) IN GENERAL.—Subject to paragraph (6), 

2 for each State for which the Secretary of Health and 

3 Human Services has approved an application under 

4 paragraph (3), the Federal matching payments (in5 cluding payments based on the Federal medical as6 sistance percentage) made to such State under sec7 tion 1903 of the Social Security Act (42 U.S.C. 

8 1396b) (excluding any increase resulting from the 

9 application of section 5001 of Public Law 111–5) 

10 shall be increased by 5.0 percentage points for pay11 ments to the State for the activities permitted under 

12 paragraph (2) for a period of one year. 

13 (2) USE OF FUNDS.—A State may only use in14 creased matching payments authorized under para15 graph (1)— 

16 (A) to strengthen the State’s enrollment 

17 and administrative resources for the purpose of 

18 improving processes for enrolling (or reinstating 

19 the enrollment of) eligible individuals (as such 

20 term is defined in section 1902(e)(15)(E) of the 

21 Social Security Act); and 

22 (B) for medical assistance (as such term is 

23 defined in section 1905(a) of the Social Secu24 rity Act) provided to such eligible individuals. 


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1 (3) APPLICATION AND AGREEMENT.—The Sec2 retary may only make payments to a State in the in3 creased amount if— 

4 (A) the State has amended the State plan 

5 under section 1902 of the Social Security Act 

6 to incorporate the requirements of subsection 

7 (e)(15) of such section; 

8 (B) the State has submitted an application 

9 to the Secretary that includes a plan for imple10 menting the requirements of section 

11 1902(e)(15) of the Social Security Act under 

12 the State’s amended State plan before the end 

13 of the 90-day period beginning on the date that 

14 the State receives increased matching payments 

15 under paragraph (1); 

16 (C) the State’s application meets the satis17 faction of the Secretary; and 

18 (D) the State enters an agreement with 

19 the Secretary that states that— 

20 (i) the State will only use the in21 creased matching funds for the uses per22 mitted under paragraph (2); and 

23 (ii) at the end of the period under 

24 paragraph (1), the State will submit to the 

25 Secretary, and make publicly available, a 


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1 report that contains the information re2 quired under paragraph (4). 

3 (4) REQUIRED REPORT INFORMATION.—The in4 formation that is required in the report under para5 graph (3)(D)(ii) includes— 

6 (A) the results of an evaluation of the im7 pact of the implementation of the requirements 

8 of section 1902(e)(15) of the Social Security 

9 Act on improving the State’s processes for en10 rolling of individuals who are released for public 

11 institutions into the Medicaid program; 

12 (B) the number of individuals who were 

13 automatically enrolled (or whose enrollment is 

14 reinstated) under such section 1902(e)(15) dur15 ing the period under paragraph (1); and 

16 (C) any other information that is required 

17 by the Secretary. 

18 (5) INCREASE IN CAP ON MEDICAID PAYMENTS

19 TO TERRITORIES.—Subject to paragraph (6), the 

20 amounts otherwise determined for Puerto Rico, the 

21 United States Virgin Islands, Guam, the Northern 

22 Mariana Islands, and American Samoa under sub23 sections (f) and (g) of section 1108 of the Social Se24 curity Act (42 6 U.S.C. 1308) shall each be in25 creased by the necessary amount to allow for the inVerDate Mar 15 2010 04:22 Jul 30, 2011 Jkt 099200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\H2704.IH H2704

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1 crease in the Federal matching payments under 

2 paragraph (1), but only for the period under such 

3 paragraph for such State. In the case of such an in4 crease for a territory, subsection (a)(1) of such sec5 tion 1108 shall be applied without regard to any in6 crease in payment made to the territory under part 

7 E of title IV of such Act that is attributable to the 

8 increase in Federal medical assistance percentage ef9 fected under paragraph (1) for the territory. 

10 (6) LIMITATIONS.— 

11 (A) TIMING.—With respect to a State, at 

12 the end of the period under paragraph (1), no 

13 increased matching payments may be made to 

14 such State under this subsection. 

15 (B) MAINTENANCE OF ELIGIBILITY.— 

16 (i) IN GENERAL.—Subject to clause 

17 (ii), a State is not eligible for an increase 

18 in its Federal matching payments under 

19 paragraph (1), or an increase in a cap 

20 amount under paragraph (5), if eligibility 

21 standards, methodologies, or procedures 

22 under its State plan under title XIX of the 

23 Social Security Act (including any waiver 

24 under such title or under section 1115 of 

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1 strictive than the eligibility standards, 

2 methodologies, or procedures, respectively, 

3 under such plan (or waiver) as in effect on 

4 the date of enactment of this Act. 

5 (ii) STATE REINSTATEMENT OF ELIGI6 BILITY PERMITTED.—A State that has re7 stricted eligibility standards, methodolo8 gies, or procedures under its State plan 

9 under title XIX of the Social Security Act 

10 (including any waiver under such title or 

11 under section 1115 of such Act (42 U.S.C. 

12 1315)) after the date of enactment of this 

13 Act, is no longer ineligible under clause (i) 

14 beginning with the first calendar quarter 

15 in which the State has reinstated eligibility 

16 standards, methodologies, or procedures 

17 that are no more restrictive than the eligi18 bility standards, methodologies, or proce19 dures, respectively, under such plan (or 

20 waiver) as in effect on such date. 

21 (C) NO WAIVER AUTHORITY.—The Sec22 retary may not waive the application of this 

23 subsection under section 1115 of the Social Se24 curity Act or otherwise. 


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1 (D) LIMITATION OF MATCHING PAYMENTS

2 TO 100 PERCENT.—In no case shall an increase 

3 in Federal matching payments under this sub4 section result in Federal matching payments 

5 that exceed 100 percent. 

6 (c) EFFECTIVE DATE.— 

7 (1) IN GENERAL.—Except as provided in para8 graph (2), the amendments made by subsection (a) 

9 shall take effect 180 days after the date of the en10 actment of this Act and shall apply to services fur11 nished on or after such date. 

12 (2) RULE FOR CHANGES REQUIRING STATE

13 LEGISLATION.—In the case of a State plan for med14 ical assistance under title XIX of the Social Security 

15 Act which the Secretary of Health and Human Serv16 ices determines requires State legislation (other than 

17 legislation appropriating funds) in order for the plan 

18 to meet the additional requirement imposed by the 

19 amendments made by this subsection, the State plan 

20 shall not be regarded as failing to comply with the 

21 requirements of such title solely on the basis of its 

22 failure to meet this additional requirement before 

23 the first day of the first calendar quarter beginning 

24 after the close of the first regular session of the 

25 State legislature that begins after the date of the enVerDate Mar 15 2010 04:22 Jul 30, 2011 Jkt 099200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\H2704.IH H2704

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1 actment of this Act. For purposes of the previous 

2 sentence, in the case of a State that has a 2-year 

3 legislative session, each year of such session shall be 

4 deemed to be a separate regular session of the State 

5 legislature. 

6 SEC. 6. SURVEY OF AND REPORT ON CORRECTIONAL FA7 CILITY PROGRAMS AIMED AT REDUCING THE 

8 SPREAD OF STIS. 

9 (a) SURVEY.—The Attorney General, after consulting 

10 with the Secretary of Health and Human Services, State 

11 officials, and community organizations, shall, to the max12 imum extent practicable, conduct a survey of all Federal 

13 and State correctional facilities, no later than 180 days 

14 after the date of enactment of this Act and annually there15 after for 5 years, to determine the following: 

16 (1) PREVENTION EDUCATION OFFERED.—The 

17 type of prevention education, information, or train18 ing offered to incarcerated persons and correctional 

19 facility staff regarding sexual violence and the 

20 spread of STIs, including whether such education, 

21 information, or training— 

22 (A) constitutes comprehensive sexuality 

23 education; 

24 (B) is compulsory for new incarcerated 

25 persons and for new staff; and 


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1 (C) is offered on an ongoing basis. 

2 (2) ACCESS TO SEXUAL BARRIER PROTECTION

3 DEVICES.—Whether incarcerated persons can— 

4 (A) possess sexual barrier protection de5 vices; 

6 (B) purchase sexual barrier protection de7 vices; 

8 (C) purchase sexual barrier protection de9 vices at a reduced cost; and 

10 (D) obtain sexual barrier protection devices 

11 without cost. 

12 (3) INCIDENCE OF SEXUAL VIOLENCE.—The in13 cidence of sexual violence and assault committed by 

14 incarcerated persons and by correctional facility 

15 staff. 

16 (4) COUNSELING, TREATMENT, AND SUP17 PORTIVE SERVICES.—Whether the correctional facil18 ity requires incarcerated persons to participate in 

19 counseling, treatment, and supportive services re20 lated to STIs, or whether it offers such programs to 

21 incarcerated persons. 

22 (5) STI TESTING.—Whether the correctional 

23 facility tests incarcerated persons for STIs or gives 

24 them the option to undergo such testing— 

25 (A) at intake; 


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1 (B) on a regular basis; and 

2 (C) prior to release. 

3 (6) STI TEST RESULTS.—The number of incar4 cerated persons who are tested for STIs and the out5 come of such tests at each correctional facility, 

6 disaggregated to include results for— 

7 (A) the type of sexually transmitted infec8 tion tested for; 

9 (B) the race and/or ethnicity of individuals 

10 tested; 

11 (C) the age of individuals tested; and 

12 (D) the gender of individuals tested. 

13 (7) PRE-RELEASE REFERRAL POLICY.—Wheth14 er incarcerated persons are informed prior to release 

15 about STI-related services or other health services in 

16 their communities, including free and low-cost coun17 seling and treatment options. 

18 (8) PRE-RELEASE REFERRALS MADE.—The 

19 number of referrals to community-based organiza20 tions or public health facilities offering STI-related 

21 or other health services provided to incarcerated per22 sons prior to release, and the type of counseling or 

23 treatment for which the referral was made. 

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1 carcerated persons that were enrolled in the State 

2 Medicaid program prior to their incarceration, in re3 instating their enrollment upon release and whether 

4 such individuals receive referrals as provided by 

5 paragraph (8) to entities that accept the State Med6 icaid program, including if applicable— 

7 (A) the number of such individuals, includ8 ing those diagnosed with the human immuno9 deficiency virus, that have been reinstated; 

10 (B) a list of obstacles to reinstating enroll11 ment or to making determinations of eligibility 

12 for reinstatement, if any; and 

13 (C) the number of individuals denied en14 rollment. 

15 (10) OTHER ACTIONS TAKEN.—Whether the 

16 correctional facility has taken any other action, in 

17 conjunction with community organizations or other18 wise, to reduce the prevalence and spread of STIs in 

19 that facility. 

20 (b) PRIVACY.—In conducting the survey, the Attor21 ney General shall not request or retain the identity of any 

22 person who has sought or been offered counseling, treat23 ment, testing, or prevention education information regard24 ing an STI (including information about sexual barrier 

25 protection devices), or who has tested positive for an STI. 


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1 (c) REPORT.—The Attorney General shall transmit 

2 to Congress and make publicly available the results of the 

3 survey required under subsection (a), both for the Nation 

4 as a whole and disaggregated as to each State and each 

5 correctional facility. To the maximum extent possible, the 

6 Attorney General shall issue the first report no later than 

7 1 year after the date of enactment of this Act and shall 

8 issue reports annually thereafter for 5 years. 

9 SEC. 7. STRATEGY. 

10 (a) DIRECTIVE TO ATTORNEY GENERAL.—The At11 torney General, in consultation with the Secretary of 

12 Health and Human Services, State officials, and commu13 nity organizations, shall develop and implement a 5-year 

14 strategy to reduce the prevalence and spread of STIs in 

15 Federal and State correctional facilities. To the maximum 

16 extent possible, the strategy shall be developed, trans17 mitted to Congress, and made publicly available no later 

18 than 180 days after the transmission of the first report 

19 required under section 6(c) of this Act. 

20 (b) CONTENTS OF STRATEGY.—The strategy shall in21 clude the following: 

22 (1) PREVENTION EDUCATION.—A plan for im23 proving prevention education, information, and 

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1 ing on sexual violence and the spread of STIs, and 

2 comprehensive sexuality education. 

3 (2) SEXUAL BARRIER PROTECTION DEVICE AC4 CESS.—A plan for expanding access to sexual barrier 

5 protection devices in correctional facilities. 

6 (3) SEXUAL VIOLENCE REDUCTION.—A plan 

7 for reducing the incidence of sexual violence among 

8 incarcerated persons and correctional facility staff, 

9 developed in consultation with the National Prison 

10 Rape Elimination Commission. 

11 (4) COUNSELING AND SUPPORTIVE SERVICES.— 

12 A plan for expanding access to counseling and sup13 portive services related to STIs in correctional facili14 ties. 

15 (5) TESTING.—A plan for testing incarcerated 

16 persons for STIs during intake, during regular 

17 health exams, and prior to release, and that— 

18 (A) is conducted in accordance with guide19 lines established by the Centers for Disease 

20 Control and Prevention; 

21 (B) includes pre-test counseling; 

22 (C) requires that incarcerated persons are 

23 notified of their option to decline testing at any 

24 time; 


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1 (D) requires that incarcerated persons are 

2 confidentially notified of their test results in a 

3 timely manner; and 

4 (E) ensures that incarcerated persons test5 ing positive for STIs receive post-test coun6 seling, care, treatment, and supportive services. 

7 (6) TREATMENT.—A plan for ensuring that 

8 correctional facilities have the necessary medicine 

9 and equipment to treat and monitor STIs and for 

10 ensuring that incarcerated persons living with or 

11 testing positive for STIs receive and have access to 

12 care and treatment services. 

13 (7) STRATEGIES FOR DEMOGRAPHIC GROUPS.— 

14 A plan for developing and implementing culturally 

15 appropriate, sensitive, and specific strategies to re16 duce the spread of STIs among demographic groups 

17 heavily impacted by STIs. 

18 (8) LINKAGES WITH COMMUNITIES AND FACILI19 TIES.—A plan for establishing and strengthening 

20 linkages to local communities and health facilities 

21 that— 

22 (A) provide counseling, testing, care, and 

23 treatment services; 


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1 (B) may receive persons recently released 

2 from incarceration who are living with STIs; 

3 and 

4 (C) accept payment through the State 

5 Medicaid program. 

6 (9) ENROLLMENT IN STATE MEDICAID PRO7 GRAMS.—Plans to ensure that incarcerated persons 

8 who were— 

9 (A) enrolled in their State Medicaid pro10 gram prior to incarceration in a correctional fa11 cility are automatically re-enrolled in such pro12 gram upon their release; and 

13 (B) not enrolled in their State Medicaid 

14 program prior to incarceration, but who are di15 agnosed with the human immunodeficiency 

16 virus while incarcerated in a correctional facil17 ity, are automatically enrolled in such program 

18 upon their release. 

19 (10) OTHER PLANS.—Any other plans devel20 oped by the Attorney General for reducing the 

21 spread of STIs or improving the quality of health 

22 care in correctional facilities. 

23 (11) MONITORING SYSTEM.—A monitoring sys24 tem that establishes performance goals related to re25 ducing the prevalence and spread of STIs in correcVerDate Mar 15 2010 04:22 Jul 30, 2011 Jkt 099200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\H2704.IH H2704

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1 tional facilities and which, where feasible, expresses 

2 such goals in quantifiable form. 

3 (12) MONITORING SYSTEM PERFORMANCE INDI4 CATORS.—Performance indicators that measure or 

5 assess the achievement of the performance goals de6 scribed in paragraph (9). 

7 (13) COST ESTIMATE.—A detailed estimate of 

8 the funding necessary to implement the strategy at 

9 the Federal and State levels for all 5 years, includ10 ing the amount of funds required by community or11 ganizations to implement the parts of the strategy in 

12 which they take part. 

13 (c) REPORT.—The Attorney General shall transmit 

14 to Congress and make publicly available an annual 

15 progress report regarding the implementation and effec16 tiveness of the strategy described in subsection (a). The 

17 progress report shall include an evaluation of the imple18 mentation of the strategy using the monitoring system and 

19 performance indicators provided for in paragraphs (9) and 

20 (10) of subsection (b). 

21 SEC. 8. APPROPRIATIONS. 

22 (a) IN GENERAL.—There are authorized to be appro23 priated such sums as may be necessary to carry out this 

24 Act for each of the fiscal years 2012 through 2018. 


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1 (b) AVAILABILITY OF FUNDS.—Amounts made avail2 able under paragraph (1) are authorized to remain avail3 able until expended. 

4 SEC. 9. DEFINITIONS. 

5 For the purposes of this Act: 

6 (1) COMMUNITY ORGANIZATION.—The term 

7 ‘‘community organization’’ means a public health 

8 care facility or a nonprofit organization which pro9 vides health- or STI-related services according to es10 tablished public health standards. 

11 (2) COMPREHENSIVE SEXUALITY EDUCATION.— 

12 The term ‘‘comprehensive sexuality education’’ 

13 means sexuality education that includes information 

14 about abstinence and about the proper use and dis15 posal of sexual barrier protection devices and which 

16 is— 

17 (A) evidence-based; 

18 (B) medically accurate; 

19 (C) age and developmentally appropriate; 

20 (D) gender and identity sensitive; 

21 (E) culturally and linguistically appro22 priate; and 

23 (F) structured to promote critical thinking, 

24 self-esteem, respect for others, and the develop25 ment of healthy attitudes and relationships. 


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1 (3) CORRECTIONAL FACILITY.—The term ‘‘cor2 rectional facility’’ means any prison, penitentiary, 

3 adult detention facility, juvenile detention facility, 

4 jail, or other facility to which persons may be sent 

5 after conviction of a crime or act of juvenile delin6 quency within the United States. 

7 (4) INCARCERATED PERSON.—The term ‘‘incar8 cerated person’’ means any person who is serving a 

9 sentence in a correctional facility after conviction of 

10 a crime. 

11 (5) SEXUALLY TRANSMITTED INFECTION.—The 

12 term ‘‘sexually transmitted infection’’ or ‘‘STI’’ 

13 means any disease or infection that is commonly 

14 transmitted through sexual activity, including HIV/ 

15 AIDS, gonorrhea, chlamydia, syphilis, genital her16 pes, viral hepatitis, and human papillomavirus. 

17 (6) SEXUAL BARRIER PROTECTION DEVICE.— 

18 The term ‘‘sexual barrier protection device’’ means 

19 any FDA-approved physical device which has not 

20 been tampered with and which reduces the prob21 ability of STI transmission or infection between sex22 ual partners, including female condoms, male 

23 condoms, and dental dams. 

24 (7) STATE.—The term ‘‘State’’ includes the 

25 District of Columbia, American Samoa, the ComVerDate Mar 15 2010 04:22 Jul 30, 2011 Jkt 099200 PO 00000 Frm 00030 Fmt 6652 Sfmt 6201 E:\BILLS\H2704.IH H2704

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1 monwealth of the Northern Mariana Islands, Guam, 

2 Puerto Rico, and the United States Virgin Islands. 

Æ 


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