Center on Domestic Violence, Trauma & Mental 
Health practice mental health and substance use co-
ercion where abusers intentionally undermine their 
partners’ sanity or sobriety, control their access to 
medication, and sabotage their treatment and recov-
ery efforts among other coercion tactics; 
(7) researchers have also found that exposure 
to multiple childhood traumas such as sexual abuse 
and domestic violence can cause long-term negative 
physical and emotional health outcomes such as 
heart disease, cancer and depression; 
(8) health care providers can identify survivors 
of violence and interventions can decrease risk for 
violence and improve health outcomes, but health 
providers need training and systems level support in 
order to do so; 
(9) Congress authorized a public health re-
sponse to victims of domestic and sexual violence in 
the Violence Against Women Act of 2005; 
(10) since its enactment, the VAWA Health 
program has trained more than 13,000 health care 
providers to assess for and respond to domestic and 
sexual violence in over 230 clinical settings serving 
more than 1.3 million patients; 
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(11) last year, the Health Resources & Services 
Administration made this issue a priority across all 
of its bureaus and released the ‘‘HRSA Strategy to 
Address Intimate Partner Violence 2017–2020’’ with 
four key priorities: 
(A) Train the Nation’s health care and 
public health workforce to address intimate 
partner violence (IPV) at the community and 
health systems levels. 
(B) Develop partnerships to raise aware-
ness about IPV within HRSA and HHS. 
(C) Increase access to quality IPV-in-
formed health care services across all popu-
lations. 
(D) Address gaps in knowledge about IPV 
risks, impacts, and interventions.; and 
(12) a strong public health response can pre-
vent and address the immediate and long-term 
health impacts of this type of violence and abuse. 
SEC. 3. GRANTS TO STRENGTHEN THE HEALTH CARE SYS-
TEM’S RESPONSE TO DOMESTIC VIOLENCE, 
DATING VIOLENCE, SEXUAL ASSAULT, AND 
STALKING, AND FOR OTHER PURPOSES. 
Section 399P of the Public Health Service Act (42 
U.S.C. 280g–4) is amended— 
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(1) in subsection (a)— 
(A) in paragraph (2), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (3), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(4) development or enhancement and imple-
mentation of training programs to improve the ca-
pacity of early childhood programs to address do-
mestic violence, dating violence, sexual assault, and 
stalking among families they serve.’’; 
(2) in subsection (b)— 
(A) in paragraph (1)— 
(i) in subparagraph (A)(ii), by insert-
ing after ‘‘and other forms of violence and 
abuse’’ the following: ‘‘(including labor and 
sex trafficking)’’; and 
(ii) in subparagraph (B)— 
(I) in clause (ii)— 
(aa) by striking ‘‘on-site ac-
cess to’’; and 
(bb) by striking ‘‘or to 
model other services appropriate 
to the geographic and cultural 
needs of a site’’ and inserting the 
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following: ‘‘or by providing fund-
ing to national, State, Tribal, or 
territorial domestic and sexual vi-
olence coalitions to improve their 
capacity to coordinate and sup-
port health advocates and health 
system partnerships’’; 
(II) in clause (iii), by striking 
‘‘and’’ at the end; 
(III) in clause (iv), by striking 
the period at the end and inserting ‘‘, 
with priority given to programs ad-
ministered through the Health Re-
sources and Services Administration, 
Office of Women’s Health; and’’; and 
(IV) by adding at the end the fol-
lowing: 
‘‘(v) the development, dissemination, 
and evaluation of best practices, tools and 
training materials for behavioral health 
professionals to identify and respond to do-
mestic violence, sexual violence, stalking, 
and dating violence.’’; and 
(B) in paragraph (2)— 
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(i) in subparagraph (A), to read as 
follows: 
‘‘(A) CHILD ABUSE AND ABUSE IN LATER 
LIFE.—To the extent consistent with the pur-
pose of this section, a grantee may address, as 
part of a comprehensive programmatic ap-
proach implemented under a grant under this 
section, issues relating to child abuse or abuse 
in later life.’’; and 
(ii) in subparagraph (C)— 
(I) in clause (ii), by striking 
‘‘elder abuse’’ and inserting ‘‘abuse in 
later life’’; 
(II) in clause (iv)— 
(aa) by inserting ‘‘, mental 
health’’ after ‘‘dental’’; 
(bb) by inserting ‘‘and cer-
tification’’ after ‘‘exams’’; and 
(cc) by striking the period at 
the end and inserting ‘‘; and’’; 
and 
(III) by adding at the end the 
following: 
‘‘(v) development of a state-level pilot 
program to improve the response of sub-
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stance use disorder treatment programs 
and systems to domestic violence, dating 
violence, sexual assault, and stalking and 
the capacity of domestic violence, dating 
violence, sexual assault, and stalking to 
serve survivors dealing with substance use 
disorder; and 
‘‘(vi) development and utilization of 
existing technical assistance and training 
resources to improve the capacity of sub-
stance use disorder treatment programs to 
address domestic violence, dating violence, 
sexual assault, and stalking among pa-
tients they serve.’’; 
(3) in subsection (d)(2)— 
(A) in subparagraph (A)— 
(i) 
by 
inserting 
‘‘or 
behavioral 
health,’’ after ‘‘a State department (or 
other division) of health,’’; and 
(ii) by striking ‘‘mental health care’’ 
and inserting ‘‘behavioral health care’’; and 
(B) in subparagraph (B)— 
(i) by striking ‘‘or health system’’ and 
inserting ‘‘behavioral health treatment sys-
tem’’; and 
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