I 
109TH CONGRESS 
1ST SESSION H. R. 4367 
To improve the health care system’s response to domestic violence, dating 
violence, sexual assault, and stalking through the training and education 
of health care providers, developing comprehensive public health re-
sponses to violence. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 17, 2005 
Mrs. CAPPS (for herself, Mr. LATOURETTE, Mr. WAXMAN, and Mrs. LOWEY) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To improve the health care system’s response to domestic 
violence, dating violence, sexual assault, and stalking 
through the training and education of health care pro-
viders, developing comprehensive public health responses 
to violence. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Domestic Violence 
Screening, Treatment, and Prevention Act’’.
SEC. 2. PURPOSE. 
It is the purpose of this Act to improve the health 
care system’s response to domestic violence, dating vio-
lence, sexual assault, and stalking through the training 
and education of health care providers, developing com-
prehensive public health responses to violence. 
SEC. 3. TRAINING AND EDUCATION OF HEALTH PROFES-
SIONALS IN DOMESTIC AND SEXUAL VIO-
LENCE. 
Part D of title VII of the Public Health Service Act 
(42 U.S.C. 294 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 758. INTERDISCIPLINARY TRAINING AND EDUCATION 
ON DOMESTIC VIOLENCE AND OTHER TYPES 
OF VIOLENCE AND ABUSE. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Director of the Health Resources and Services Adminis-
tration, shall award grants under this section to develop 
interdisciplinary training and education programs that 
provide undergraduate, graduate, post-graduate medical, 
nursing (including advanced practice nursing students), 
and other health professions students with an under-
standing of, and clinical skills pertinent to, domestic vio-
lence, sexual assault, stalking, and dating violence. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under this section an entity shall—
‘‘(1) be an accredited school of allopathic or os-
teopathic medicine; 
‘‘(2) prepare and submit to the Secretary an 
application at such time, in such manner, and con-
taining such information as the Secretary may re-
quire, including— 
‘‘(A) information to demonstrate that the 
applicant includes the meaningful participation 
of a school of nursing and at least one other 
school of health professions or graduate pro-
gram in public health, dentistry, social work, 
midwifery, or behavioral and mental health; 
‘‘(B) strategies for the dissemination and 
sharing of curricula and other educational ma-
terials developed under the grant to other inter-
ested medical and nursing schools and national 
resource repositories for materials on domestic 
violence and sexual assault; and 
‘‘(C) a plan for consulting with, and com-
pensating community-based coalitions or indi-
viduals who have experience and expertise in 
issues related to domestic violence, sexual as-
sault, dating violence, and stalking for services 
provided under the program carried out under 
the grant.
‘‘(c) USE OF FUNDS.— 
‘‘(1) 
REQUIRED
USES.—Amounts 
provided 
under a grant under this section shall be used to— 
‘‘(A) fund interdisciplinary training and 
education projects that are designed to train 
medical, nursing, and other health professions 
students and residents to identify and provide 
health care services (including mental or behav-
ioral health care services and referrals to appro-
priate community services) to individuals who 
are or who have experienced domestic violence, 
sexual assault, and stalking or dating violence; 
and 
‘‘(B) plan and develop culturally competent 
clinical components for integration into ap-
proved residency training programs that ad-
dress health issues related to domestic violence, 
sexual assault, dating violence, and stalking, 
along with other forms of violence as appro-
priate, and include the primacy of victim safety 
and confidentiality. 
‘‘(2) PERMISSIVE
USES.—Amounts provided 
under a grant under this section may be used to— 
‘‘(A) offer community-based training op-
portunities in rural areas for medical, nursing,
and other students and residents on domestic 
violence, sexual assault, stalking, and dating vi-
olence, and other forms of violence and abuse, 
which may include the use of distance learning 
networks and other available technologies need-
ed to reach isolated rural areas; or 
‘‘(B) provide stipends to students from ra-
cial and ethnic population groups who are 
underrepresented in the health professions as 
necessary to promote and enable their partici-
pation in clerkships, preceptorships, or other 
offsite training experiences that are designed to 
develop health care clinical skills related to do-
mestic violence, sexual assault, dating violence, 
and stalking. 
‘‘(3) REQUIREMENTS.— 
‘‘(A) CONFIDENTIALITY
AND
SAFETY.— 
Grantees under this section shall ensure that all 
educational programs developed with grant 
funds address issues of confidentiality and pa-
tient safety, and that faculty and staff associ-
ated with delivering educational components are 
fully trained in procedures that will protect the 
immediate and ongoing security of the patients, 
patient records, and staff. Advocacy-based coali-
tions or other expertise available in the commu-
nity shall be consulted on the development and 
adequacy of confidentially and security proce-
dures, and shall be fairly compensated by 
grantees for their services. 
‘‘(B) RURAL
PROGRAMS.—Rural training 
programs carried out under paragraph (2)(A) 
shall reflect adjustments in protocols and proce-
dures or referrals that may be needed to protect 
the confidentiality and safety of patients who 
live in small or isolated communities and who 
are currently or have previously experienced vio-
lence or abuse. 
‘‘(4) CHILD AND ELDER ABUSE.—Issues related 
to child and elder abuse may be addressed as part 
of a comprehensive programmatic approach imple-
mented under a grant under this section. 
‘‘(d) REQUIREMENTS OF GRANTEES.— 
‘‘(1) LIMITATION
ON
ADMINISTRATIVE
EX-
PENSES.—A grantee shall not use more than 10 per-
cent of the amounts received under a grant under 
this section for administrative expenses. 
‘‘(2) CONTRIBUTION
OF
FUNDS.—A grantee 
under this section, and any entity receiving assist-
ance under the grant for training and education,
shall contribute non-Federal funds, either directly or 
through in-kind contributions, to the costs of the ac-
tivities to be funded under the grant in an amount 
that is not less than 25 percent of the total cost of 
such activities. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$3,000,000 for each of fiscal years 2006 through 2010. 
Amounts appropriated under this subsection shall remain 
available until expended.’’. 
SEC. 4. GRANTS TO FOSTER PUBLIC HEALTH RESPONSES 
TO DOMESTIC VIOLENCE, DATING VIOLENCE, 
SEXUAL ASSAULT, AND STALKING GRANTS. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 399P. GRANTS TO FOSTER PUBLIC HEALTH RE-
SPONSES TO DOMESTIC VIOLENCE, DATING 
VIOLENCE, SEXUAL ASSAULT, AND STALKING. 
‘‘(a) AUTHORITY TO AWARD GRANTS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall award grants to eligi-
ble State, tribal, territorial, or local entities to 
strengthen the response of State, tribal, territorial,
or local health care systems to domestic violence, 
dating violence, sexual assault, and stalking. 
‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re-
ceive a grant under this section, an entity shall— 
‘‘(A) be— 
‘‘(i) a State department (or other divi-
sion) of health, a State domestic or sexual 
assault coalition or service-based program, 
or any other nonprofit, nongovernmental, 
tribal, territorial, or State entity with a 
history of effective work in the fields of do-
mestic violence, dating violence, sexual as-
sault or stalking, and health care; or 
‘‘(ii) a nonprofit domestic violence, 
dating violence, sexual assault, or stalking 
service-based program, a local department 
(or other division) of health, a local health 
clinic, hospital, or health system, or any 
other nonprofit, tribal, or local entity with 
a history of effective work in the field of 
domestic or sexual violence and health; 
‘‘(B) prepare and submit to the Secretary 
an application at such time, in such manner, 
and containing such agreements, assurances, 
and information as the Secretary determines to
be necessary to carry out the purposes for 
which the grant is to be made; and 
‘‘(C) demonstrate that the entity is rep-
resenting a team of organizations and agencies 
working collaboratively to strengthen the re-
sponse of the health care system involved to do-
mestic violence, dating violence, sexual assault, 
or stalking and that such team includes domes-
tic violence, dating violence, sexual assault or 
stalking and health care organizations. 
‘‘(3) DURATION.—A program conducted under 
a grant awarded under this section shall not exceed 
3 years. 
‘‘(b) USE OF FUNDS.— 
‘‘(1) 
IN
GENERAL.—An 
entity 
shall 
use 
amounts received under a grant under this section to 
design and implement comprehensive strategies to 
improve the response of the health care system in-
volved to domestic or sexual violence in clinical and 
public health settings, hospitals, clinics, managed 
care settings (including behavioral and mental 
health), and other health settings. 
‘‘(2) MANDATORY STRATEGIES.—Strategies im-
plemented under paragraph (1) shall include the fol-
lowing:
‘‘(A) The implementation, dissemination, 
and evaluation of policies and procedures to 
guide health care professionals and behavioral 
and public health staff in responding to domes-
tic violence, dating violence, sexual assault, and 
stalking, including strategies to ensure that 
health information is maintained in a manner 
that protects the patient’s privacy and safety 
and prohibits insurance discrimination. 
‘‘(B) The development of on-site access to 
services to address the safety, medical, mental 
health, and economic needs of patients either by 
increasing the capacity of existing health care 
professionals and behavioral and public health 
staff to address domestic violence, dating vio-
lence, sexual assault, and stalking, by con-
tracting with or hiring domestic or sexual as-
sault advocates to provide the services, or to 
model other services appropriate to the geo-
graphic and cultural needs of a site. 
‘‘(C) The development or adaptation and 
dissemination of education materials for pa-
tients and health care professionals and behav-
ioral and public health staff.
‘‘(D) The evaluation of practice and the in-
stitutionalization of identification, intervention, 
and documentation including quality improve-
ment measurements. 
‘‘(3) PERMISSIVE STRATEGIES.—Strategies im-
plemented under paragraph (1) may include the fol-
lowing: 
‘‘(A) Where appropriate, the development 
of training modules and policies that address 
the overlap of child abuse, domestic violence, 
dating violence, sexual assault, and stalking and 
elder abuse as well as childhood exposure to do-
mestic violence. 
‘‘(B) The creation, adaptation, and imple-
mentation of public education campaigns for 
patients concerning domestic violence, dating vi-
olence, sexual assault, and stalking prevention. 
‘‘(C) The development, adaptation, and 
dissemination of domestic violence, dating vio-
lence, sexual assault, and stalking education 
materials to patients and health care profes-
sionals and behavioral and public health staff. 
‘‘(D) The promotion of the inclusion of do-
mestic violence, dating violence, sexual assault, 
and stalking into health professional training
schools, including medical, dental, nursing 
school, social work, and mental health cur-
riculum. 
‘‘(E) The integration of domestic violence, 
dating violence, sexual assault, and stalking 
into health care accreditation and professional 
licensing examinations, such as medical, dental, 
social work, and nursing boards. 
‘‘(c) ALLOCATION OF FUNDS.—Funds appropriated 
under this section shall be distributed equally between 
State and local programs. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to award grants under 
this section, $5,000,000 for each of fiscal years 2006 
through 2010.’’. 
SEC. 5. IMPROVING FEDERAL HEALTH PROGRAMS’ RE-
SPONSE TO DOMESTIC VIOLENCE, DATING VI-
OLENCE, SEXUAL ASSAULT, AND STALKING. 
(a) TRAINING GRANTS UNDER THE MATERNAL AND 
CHILD HEALTH SERVICES BLOCK GRANT.— 
(1) PREFERENCE IN CERTAIN FUNDING.—Sec-
tion 502(b)(2) of the Social Security Act (42 U.S.C. 
702(b)(2)) is amended by adding at the end the fol-
lowing:
‘‘(C) Of the amounts retained for projects described 
in subparagraphs (A) through (F) of section 501(a)(3), 
the Secretary shall provide preference to qualified appli-
cants that demonstrate that the activities to be carried 
out with such amounts include training of service pro-
viders in how to identify and treat the health effects of 
domestic violence, dating violence, sexual assault, or stalk-
ing, including children who have been exposed to domestic 
or dating violence. Such training should include— 
‘‘(i) identifying patients of clients experiencing 
domestic violence, dating violence sexual assault, or 
stalking; 
‘‘(ii) assessing the immediate and short-term 
safety of the patient or client, the impact of the 
abuse on the health of the patient, and assisting the 
patient in developing a plan to promote his or her 
safety; 
‘‘(iii) examining and treating such patients or 
clients within the scope of the health professional’s 
discipline, training, and practice (including providing 
medical advice regarding the dynamics and nature of 
domestic violence, dating violence sexual assault, or 
stalking); 
‘‘(iv) maintaining complete medical or forensic 
records that include the documentation of the exam-
ination, treatment given, and referrals made, and re-
cording the location and nature of the victim’s inju-
ries, and establishing mechanisms to ensure the pri-
vacy and confidentiality of those medical records; 
‘‘(v) referring the patient or client to public and 
private nonprofit entities that provide services for 
such victims; and 
‘‘(vi) ensuring that all services are provided in 
a linguistically and culturally relevant manner.’’. 
(2) REQUIREMENT FOR PORTION OF EXPENDI-
TURES
ON
DOMESTIC
VIOLENCE
IDENTIFICATION 
AND TREATMENT.—Section 505(a)(5) of the Social 
Security Act (42 U.S.C. 705(a)(5)) is amended— 
(A) in subparagraph (E), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (F), by striking the 
period and inserting ‘‘; and’’; and 
(C) by inserting after subparagraph (F), 
the following: 
‘‘(G) the State will set aside a reasonable 
portion (based upon the State’s previous use of 
funds under this title) of the funds provided for 
domestic violence, dating violence, sexual as-
sault, or stalking services.’’.
(3) REPORTING
DATA.—Section 506(a)(2) of 
the Social Security Act (42 U.S.C. 706(a)(2)) is 
amended by inserting after subparagraph (E) the 
following: 
‘‘(F) Information on how funds provided under 
this title are used to identify and treat domestic vio-
lence, dating violence, sexual assault, or stalking.’’. 
(4) SEPARATE PROGRAM FOR DOMESTIC VIO-
LENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND 
STALKING IDENTIFICATION AND TREATMENT.—Title 
V of the Social Security Act (42 U.S.C. 701 et seq.) 
is amended by adding at the end the following: 
‘‘SEC. 511. SEPARATE PROGRAM FOR DOMESTIC VIOLENCE, 
DATING VIOLENCE, SEXUAL ASSAULT AND 
STALKING SCREENING AND TREATMENTS. 
‘‘(a) ALLOTMENTS.—For the purpose described in 
subsection (b), the Secretary shall, for fiscal year 2006 
and each subsequent fiscal year, allot to each State that 
has transmitted an application for the fiscal year under 
section 505(a) an amount equal to the product of— 
‘‘(1) the amount appropriated under subsection 
(d) for the fiscal year; and 
‘‘(2) the percentage determined for the State 
under section 502(c)(1)(B)(ii).
‘‘(b) PURPOSE.—The purpose of an allotment under 
subsection (a) with respect to a State is to enable the 
State to provide for domestic violence, dating violence, sex-
ual assault, or stalking identification and treatment, in-
cluding the provision of domestic violence, dating violence, 
sexual assault, or stalking identification, treatment serv-
ices, increasing the number of persons identified, assessed, 
treated, and referred, and including training of health care 
professionals, and behavioral and public health staff, on 
how to identify and respond to adult and minor patients 
experiencing domestic violence, dating violence, sexual as-
sault, or stalking. Such training shall include— 
‘‘(1) identifying patients of clients experiencing 
domestic violence, dating violence sexual assault, or 
stalking; 
‘‘(2) assessing the immediate and short-term 
safety of the patient or client, the impact of the 
abuse on the health of the patient, and assisting the 
patient in developing a plan to promote his or her 
safety; 
‘‘(3) examining and treating such patients or 
clients within the scope of the health professional’s 
discipline, training, and practice (including providing 
medical advice regarding the dynamics and nature of
domestic violence, dating violence sexual assault, or 
stalking); 
‘‘(4) maintaining complete medical or forensic 
records that include the documentation of the exam-
ination, treatment given, and referrals made, and re-
cording the location and nature of the victim’s inju-
ries, and establishing mechanisms to ensure the pri-
vacy and confidentiality of those medical records; 
‘‘(5) referring the patient or client to public and 
private nonprofit entities that provide services for 
such victims; and 
‘‘(6) ensuring that all services are provided in 
a linguistically and culturally relevant manner. 
‘‘(c) APPLICATION OF PROVISIONS.— 
‘‘(1) IN GENERAL.—Sections 503, 507, and 508 
apply to allotments under subsection (a) to the same 
extent and in the same manner as such sections 
apply to allotments under section 502(c). 
‘‘(2) SECRETARIAL DISCRETION.—Sections 505 
and 506 apply to allotments under subsection (a) to 
the extent determined by the Secretary to be appro-
priate. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of making allotments under subsection (a), there
are authorized to be appropriated $4,000,000 for each of 
fiscal years 2006 through 2010.’’. 
(b) DOMESTIC VIOLENCE, DATING VIOLENCE, SEX-
UAL ASSAULT, AND STALKING IDENTIFICATION
AND 
TREATMENT SERVICES AT COMMUNITY HEALTH CEN-
TERS.—Part P of title III of the Public Health Service 
Act (42 U.S.C. 280g et seq.), as amended by section 5, 
is further amended by adding at the end the following: 
‘‘SEC. 399P–1. DOMESTIC VIOLENCE, DATING VIOLENCE, 
SEXUAL ASSAULT AND STALKING PREVEN-
TION, 
IDENTIFICATION, 
AND 
TREATMENT 
GRANTS. 
‘‘(a) GRANTS AUTHORIZED.—The Secretary is au-
thorized to award grants to eligible entities to improve the 
identification and treatment of domestic violence, dating 
violence, sexual assault, or stalking. 
‘‘(b) USE OF FUNDS.—Grants awarded under sub-
section (a) may be used for activities such as— 
‘‘(1) the implementation, dissemination, and 
evaluation of policies and procedures to guide health 
care and behavioral health care professionals and 
other staff responding to domestic violence, dating 
violence, sexual assault, or stalking; 
‘‘(2) the provision of training and follow-up 
technical assistance to health care professionals and