I
105TH CONGRESS
2D SESSION
H. R. 4477
To provide grants to strengthen State and local health care systems’ response
to domestic violence by building the capacity of health care professionals
and staff to identify, address, and prevent domestic violence.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 6, 1998
Mrs. LOWEY introduced the following bill; which was referred to the
Committee on Education and the Workforce
A BILL
To provide grants to strengthen State and local health care
systems’ response to domestic violence by building the
capacity of health care professionals and staff to identify,
address, and prevent domestic violence.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. GRANTS TO ADDRESS DOMESTIC VIOLENCE IN
HEALTH CARE SETTINGS.
(a) IN GENERAL.—The Family Violence Prevention
and Services Act (42 U.S.C. 10401 et seq.) is amended
by adding at the end the following:
‘‘SEC. 319. GRANTS TO ADDRESS DOMESTIC VIOLENCE IN
HEALTH CARE SETTINGS.
‘‘(a) GENERAL PURPOSE GRANTS.—The Secretary,
acting through the Office of Family Violence and Preven-
tion Services of the Administration for Children and Fam-
ilies, may award grants to eligible State and local entities
to strengthen the State and local health care system’s re-
sponse to domestic violence by building the capacity of
health care professionals and staff to identify, address,
and prevent domestic violence.
‘‘(b) STATE GRANTS.—
‘‘(1) IN GENERAL.—The Secretary may award
grants under subsection (a) to entities eligible under
paragraph (2) for the conduct of not to exceed 10
Statewide programs for the design and implementa-
tion of Statewide strategies to enable health care
workers to improve the health care system’s re-
sponse to treatment and prevention of domestic vio-
lence as provided for in subsection (d).
‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re-
ceive a grant under paragraph (1) an entity shall—
‘‘(A) be a State health department, non-
profit State domestic violence coalition, State
professional medical society, State health pro-
fessional association, or other nonprofit or
State entity with a documented history of effec-
tive work in the field of domestic violence;
‘‘(B) demonstrate to the Secretary that
such entity is representing a team of organiza-
tions and agencies working collaboratively to
strengthen the health care system’s response to
domestic violence; and
‘‘(C) prepare and submit to the Secretary
an application at such time, in such manner,
and containing such information as the Sec-
retary may require.
‘‘(3) LIMITATION.—The Secretary may not
award a grant to a State health department under
paragraph (1) unless the State health department
can certify that State laws, policies, and practices do
not require the mandatory reporting of domestic vio-
lence by health care professionals and staff when the
victim is an adult.
‘‘(4) TERM AND AMOUNT.—A grant under this
section shall be for a term of 4 years and for an
amount not to exceed $2,000,000 for each such
year.
‘‘(c) LOCAL DEMONSTRATION GRANTS.—
‘‘(1) IN GENERAL.—The Secretary may award
grants under subsection (a) to entities eligible under
paragraph (2) for the conduct of not to exceed 10
demonstration projects for the design and implemen-
tation of a strategy to improve the response of local
health care professionals and staff to the treatment
and prevention of domestic violence.
‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re-
ceive a grant under paragraph (1) an entity shall—
‘‘(A) be a local health department, local
nonprofit domestic violence organization or
service provider, local professional medical soci-
ety or health professional association, or other
nonprofit or local government entity that has a
documented history of effective work in the field
of domestic violence;
‘‘(B) demonstrate to the Secretary that
such entity is representing a team of organiza-
tions working collaboratively to strengthen the
health care system’s response to domestic vio-
lence; and
‘‘(C) prepare and submit to the Secretary
an application at such time, in such manner,
and containing such information as the Sec-
retary may require.
‘‘(3) TERM AND AMOUNT.—A grant under this
section shall be for a term of 3 years and for an
amount not to exceed $450,000 for each such year.
‘‘(d) USE OF FUNDS.—Amounts provided under a
grant under this section shall be used to design and imple-
ment comprehensive Statewide and local strategies to im-
prove the health care setting’s response to domestic vio-
lence in hospitals, clinics, managed care settings, emer-
gency medical services, and other health care systems.
Such a strategy shall include—
‘‘(1) the development, implementation, and dis-
semination of policies and procedures to guide health
care professionals and staff responding to domestic
violence;
‘‘(2) the training of, and providing follow-up
technical assistance to, health care professionals and
staff to screen for domestic violence, and then to ap-
propriately assess, record in medical records, treat,
and refer patients who are victims of domestic vio-
lence to domestic violence services;
‘‘(3) the implementation of practice guidelines
for widespread screening and recording mechanisms
to identify and document domestic violence, and the
institutionalization of such guidelines and mecha-
nisms in quality improvement measurements such as
patient record reviews, staff interviews, patient sur-
veys, or other methods used to evaluate and enhance
staff compliance with protocols;
‘‘(4) the development of an on-site program to
address the safety, medical, mental health, and eco-
nomic needs of patients who are victims of domestic
violence achieved either by increasing the capacity of
existing health care professionals and staff to ad-
dress these issues or by contracting with or hiring
domestic violence advocates to provide the services;
‘‘(5) the development of innovative and effective
comprehensive approaches to domestic violence iden-
tification, treatment, and prevention models unique
to managed care settings, such as—
‘‘(A) exploring ways to include com-
pensated health care professionals and staff for
screening and other services related to domestic
violence;
‘‘(B) developing built-in incentives such as
billing mechanisms and protocols to encourage
health care professionals and staff to implement
screening and other domestic violence pro-
grams; and
‘‘(C) contracting with community agencies
as vendors to provide domestic violence victims