I

103D CONGRESS

1ST SESSION H. R. 1829

To amend the Public Health Service Act to provide for demonstration projects

for the identification by health care providers of victims of domestic

violence and sexual assault, to provide for the education of the public

on the consequences to the public health of such violence and assault,

and to provide for epidemiological research on such violence and assault.

IN THE HOUSE OF REPRESENTATIVES

APRIL 22, 1993

Mr. MCDERMOTT (for himself, Mrs. MORELLA, and Mr. KREIDLER) introduced the following bill; which was referred to the Committee on Energy

and Commerce

A BILL

To amend the Public Health Service Act to provide for

demonstration projects for the identification by health

care providers of victims of domestic violence and sexual

assault, to provide for the education of the public on

the consequences to the public health of such violence

and assault, and to provide for epidemiological research

on such violence and assault.

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 ‘‘Women’s Violence5 Related Injury Reduction Act’’.
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1 SEC. 2. FINDINGS.

2 The Congress finds the following:

3 (1) Domestic violence and sexual assault rep4 resent serious threats to the health and well-being of

5 millions of women in the United States.

6 (2) Violence against women has serious health

7 consequences for its victims, including fatality, se8 vere trauma, repeated physical injuries, and chronic

9 stress-related disorder.

10 (3) Violence against women has serious mental

11 health consequences for its victims, including sub12 stance abuse, severe psychological trauma, and sui13 cide.

14 (4) Approximately 4,000,000 women in the

15 United States are victims of domestic violence each

16 year.

17 (5) One of two women is a victim of domestic

18 violence or sexual assault during her lifetime.

19 (6) Battering is the leading cause of injury to

20 women.

21 (7) It has been estimated that 1 in 6 pregnant

22 women are battered, resulting in increased rates of

23 miscarriage, stillbirths, and low-birthweight babies.

24 (8) Domestic violence may account for as much

25 as one-third of emergency-room visits by women, an

26 annual total of approximately 28,700 such visits.
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1 (9) Estimates based on the National Crime

2 Survey provide that domestic violence accounts for

3 21,000 hospitalizations, 99,800 days of hospitaliza4 tion, and 39,900 visits to a physician each year.

5 (10) Fewer than 5 percent of injured women

6 are correctly diagnosed by medical personnel as

7 being victims of domestic violence.

8 (11) Hospitals and clinics do not have a uni9 form set of protocols for the identification and refer10 ral of victims of domestic violence and sexual as11 sault, or for the training of health care professionals

12 to perform such functions.

13 (12) A national surveillance system for monitor14 ing the health effects of domestic violence and sexual

15 assault should be established to determine the na16 ture and extent of such violence and assault in the

17 United States.

18 SEC. 3. ESTABLISHMENT OF CERTAIN HEALTH PROGRAMS

19 REGARDING DOMESTIC VIOLENCE AND SEX20 UAL ASSAULT.

21 Part B of title III of the Public Health Service Act

22 (42 U.S.C. 243 et seq.), as amended by section 308 of

23 Public Law 102-531 (106 Stat. 3495), is amended by in24 serting after section 317D the following section:
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1 ‘‘HEALTH PROGRAMS REGARDING DOMESTIC VIOLENCE

2 AND SEXUAL ASSAULT

3 ‘‘SEC. 317E. (a) DEMONSTRATION PROJECTS FOR

4 IDENTIFICATION AND REFERRALS OF VICTIMS.—

5 ‘‘(1) IN GENERAL.—The Secretary, acting

6 through the Director of the Centers for Disease

7 Control and Prevention, may make grants to public

8 and nonprofit private entities for the purpose of car9 rying out demonstration projects in which health

10 care providers, in providing such care—

11 ‘‘(A) identify individuals whose medical

12 condition or statements indicate that the indi13 viduals are victims of domestic violence or sex14 ual assault; and

15 ‘‘(B) refer the individuals to entities that

16 provide services regarding such violence and as17 sault, including referrals for counseling, housing

18 (including temporary housing), legal services,

19 and services of community organizations.

20 ‘‘(2) TRAINING.—The Secretary may authorize

21 grantees under paragraph (1) to expend the grants

22 to train health care providers to carry out the activi23 ties described in such paragraph.

24 ‘‘(3) PROTOCOLS FOR IDENTIFICATION, REFER25 RALS, AND TRAINING.—The Secretary may make a
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1 grant under paragraph (1) only if the applicant for

2 the grant agrees that the demonstration project in3 volved will not begin operation until the Secretary

4 approves for the project protocols for identifying and

5 referring victims, and training health care providers,

6 for purposes of such paragraph. The Secretary may

7 authorize grantees under such paragraph to expend

8 the grants to develop such protocols.

9 ‘‘(4) CONSULTATION WITH RELEVANT ENTI10 TIES.—The Secretary may make a grant under

11 paragraph (1) only if the applicant involved has, in

12 developing the proposal of the applicant for a dem13 onstration project under such paragraph, consulted

14 with public and nonprofit private entities that, in the

15 geographic area in which the project is to be carried

16 out, provide services regarding domestic violence or

17 sexual assault.

18 ‘‘(5) REPORTS.—The Secretary may make a

19 grant under paragraph (1) only if the applicant for

20 the grant agrees to submit to the Secretary a report

21 describing the activities of the project under such

22 paragraph for the fiscal year for which the grant is

23 made.

24 ‘‘(b) PUBLIC EDUCATION.—The Secretary, acting

25 through the Director of the Centers for Disease Control
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1 and Prevention, shall carry out a program to educate

2 health care providers and the public on the consequences

3 to the public health of domestic violence and sexual as4 sault.

5 ‘‘(c) EPIDEMIOLOGICAL RESEARCH.—

6 ‘‘(1) IN GENERAL.—The Secretary, acting

7 through the Director of the Centers for Disease

8 Control and Prevention, shall provide for the con9 duct of epidemiological research on domestic violence

10 and sexual assault. In providing for such research,

11 the Secretary shall ensure that, with respect to such

12 violence and assault, data is collected on—

13 ‘‘(A) the incidence of cases and the effect

14 of the cases on the costs of health care in the

15 United States;

16 ‘‘(B) the type and severity of injuries sus17 tained and the type and severity of any other

18 resulting health conditions;

19 ‘‘(C) the extent to which victims seek

20 treatment, including a comparison of the inci21 dence of cases with the incidence of seeking

22 treatment;

23 ‘‘(D) a description of common cir24 cumstances influencing victims not to seek

25 treatment;
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1 ‘‘(E) the types of medical facilities and

2 health care providers from which victims seek

3 treatment; and

4 ‘‘(F) the demographic characteristics of

5 the individuals from whom data described in

6 subparagraphs (A) through (E) is collected.

7 ‘‘(2) NATIONAL SYSTEM.—In carrying out para8 graph (1), the Secretary shall cooperate with the

9 States for the purpose of establishing, to the extent

10 practicable, a national system for the collection of

11 data regarding domestic violence and sexual assault.

12 ‘‘(3) CONFIDENTIALITY.—Standards of con13 fidentiality under section 308(d) shall apply to data

14 collected under paragraph (1) to the same extent

15 and in the same manner as such section applies to

16 information obtained under section 304, 306, or

17 307.

18 ‘‘(4) REPORT.—Not later than February 1,

19 1996, and every 2 years thereafter, the Secretary

20 shall submit to the Congress a report summarizing

21 the data collected under paragraph (1) for the

22 preceding 2 years.

23 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—

24 ‘‘(1) IN GENERAL.—For the purpose of carry25 ing out this section, there are authorized to be ap-
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1 propriated $20,000,000 for fiscal year 1994, and

2 such sums as may be necessary for each of the fiscal

3 years 1995 through 1997.

4 ‘‘(2) ALLOCATION FOR DEMONSTRATION

5 PROJECTS.—Of the amounts appropriated under

6 paragraph (1) for a fiscal year, the Secretary shall

7 make available not less than 60 percent for grants

8 under subsection (a).’’.

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