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) intro-
duced 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.
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 ‘‘Women’s Violence-
Related Injury Reduction Act’’.
SEC. 2. FINDINGS.
The Congress finds the following:
(1) Domestic violence and sexual assault rep-
resent serious threats to the health and well-being of
millions of women in the United States.
(2) Violence against women has serious health
consequences for its victims, including fatality, se-
vere trauma, repeated physical injuries, and chronic
stress-related disorder.
(3) Violence against women has serious mental
health consequences for its victims, including sub-
stance abuse, severe psychological trauma, and sui-
cide.
(4) Approximately 4,000,000 women in the
United States are victims of domestic violence each
year.
(5) One of two women is a victim of domestic
violence or sexual assault during her lifetime.
(6) Battering is the leading cause of injury to
women.
(7) It has been estimated that 1 in 6 pregnant
women are battered, resulting in increased rates of
miscarriage, stillbirths, and low-birthweight babies.
(8) Domestic violence may account for as much
as one-third of emergency-room visits by women, an
annual total of approximately 28,700 such visits.
(9) Estimates based on the National Crime
Survey provide that domestic violence accounts for
21,000 hospitalizations, 99,800 days of hospitaliza-
tion, and 39,900 visits to a physician each year.
(10) Fewer than 5 percent of injured women
are correctly diagnosed by medical personnel as
being victims of domestic violence.
(11) Hospitals and clinics do not have a uni-
form set of protocols for the identification and refer-
ral of victims of domestic violence and sexual as-
sault, or for the training of health care professionals
to perform such functions.
(12) A national surveillance system for monitor-
ing the health effects of domestic violence and sexual
assault should be established to determine the na-
ture and extent of such violence and assault in the
United States.
SEC. 3. ESTABLISHMENT OF CERTAIN HEALTH PROGRAMS
REGARDING DOMESTIC VIOLENCE AND SEX-
UAL ASSAULT.
Part B of title III of the Public Health Service Act
(42 U.S.C. 243 et seq.), as amended by section 308 of
Public Law 102-531 (106 Stat. 3495), is amended by in-
serting after section 317D the following section:
‘‘HEALTH PROGRAMS REGARDING DOMESTIC VIOLENCE
AND SEXUAL ASSAULT
‘‘SEC. 317E. (a) DEMONSTRATION PROJECTS FOR
IDENTIFICATION AND REFERRALS OF VICTIMS.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention, may make grants to public
and nonprofit private entities for the purpose of car-
rying out demonstration projects in which health
care providers, in providing such care—
‘‘(A) identify individuals whose medical
condition or statements indicate that the indi-
viduals are victims of domestic violence or sex-
ual assault; and
‘‘(B) refer the individuals to entities that
provide services regarding such violence and as-
sault, including referrals for counseling, housing
(including temporary housing), legal services,
and services of community organizations.
‘‘(2) TRAINING.—The Secretary may authorize
grantees under paragraph (1) to expend the grants
to train health care providers to carry out the activi-
ties described in such paragraph.
‘‘(3) PROTOCOLS FOR IDENTIFICATION, REFER-
RALS, AND TRAINING.—The Secretary may make a
grant under paragraph (1) only if the applicant for
the grant agrees that the demonstration project in-
volved will not begin operation until the Secretary
approves for the project protocols for identifying and
referring victims, and training health care providers,
for purposes of such paragraph. The Secretary may
authorize grantees under such paragraph to expend
the grants to develop such protocols.
‘‘(4) CONSULTATION
WITH
RELEVANT
ENTI-
TIES.—The Secretary may make a grant under
paragraph (1) only if the applicant involved has, in
developing the proposal of the applicant for a dem-
onstration project under such paragraph, consulted
with public and nonprofit private entities that, in the
geographic area in which the project is to be carried
out, provide services regarding domestic violence or
sexual assault.
‘‘(5) REPORTS.—The Secretary may make a
grant under paragraph (1) only if the applicant for
the grant agrees to submit to the Secretary a report
describing the activities of the project under such
paragraph for the fiscal year for which the grant is
made.
‘‘(b) PUBLIC EDUCATION.—The Secretary, acting
through the Director of the Centers for Disease Control
and Prevention, shall carry out a program to educate
health care providers and the public on the consequences
to the public health of domestic violence and sexual as-
sault.
‘‘(c) EPIDEMIOLOGICAL RESEARCH.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention, shall provide for the con-
duct of epidemiological research on domestic violence
and sexual assault. In providing for such research,
the Secretary shall ensure that, with respect to such
violence and assault, data is collected on—
‘‘(A) the incidence of cases and the effect
of the cases on the costs of health care in the
United States;
‘‘(B) the type and severity of injuries sus-
tained and the type and severity of any other
resulting health conditions;
‘‘(C) the extent to which victims seek
treatment, including a comparison of the inci-
dence of cases with the incidence of seeking
treatment;
‘‘(D) 
a 
description 
of 
common 
cir-
cumstances influencing victims not to seek
treatment;
‘‘(E) the types of medical facilities and
health care providers from which victims seek
treatment; and
‘‘(F) the demographic characteristics of
the individuals from whom data described in
subparagraphs (A) through (E) is collected.
‘‘(2) NATIONAL SYSTEM.—In carrying out para-
graph (1), the Secretary shall cooperate with the
States for the purpose of establishing, to the extent
practicable, a national system for the collection of
data regarding domestic violence and sexual assault.
‘‘(3) CONFIDENTIALITY.—Standards of con-
fidentiality under section 308(d) shall apply to data
collected under paragraph (1) to the same extent
and in the same manner as such section applies to
information obtained under section 304, 306, or
307.
‘‘(4) REPORT.—Not later than February 1,
1996, and every 2 years thereafter, the Secretary
shall submit to the Congress a report summarizing
the data collected under paragraph (1) for the
preceding 2 years.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—For the purpose of carry-
ing out this section, there are authorized to be ap-
propriated $20,000,000 for fiscal year 1994, and
such sums as may be necessary for each of the fiscal
years 1995 through 1997.
‘‘(2) 
ALLOCATION
FOR
DEMONSTRATION
PROJECTS.—Of the amounts appropriated under
paragraph (1) for a fiscal year, the Secretary shall
make available not less than 60 percent for grants
under subsection (a).’’.
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